System VP Utilization Management

**Job Summary and Responsibilities**

The System Vice President of Utilization Management is a key member of the healthcare organization’s leadership team and is charged with meeting the organization’s goals and objectives for assuring the effective, efficient utilization of health care services. This role will be an expert on matters regarding physician practice patterns, over and under-utilization of resources, medical necessity, levels of care, care progression, compliance with governmental and private payer regulations, and appropriate physician coding and documentation requirements.

Under direction of the System Senior Vice President of Clinical Regulatory and Revenue Enhancement, this role will have responsibility and accountability for creating, implementing, and leading an integrated system-wide utilization management program which includes comprehensive denials management. This role is critical to maintaining the organization’s competitive position in the he...

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