Executive Searches
Vice President, Utilization Management
Behavioral Health Operator
Position Summary
The Vice President, Utilization Management will serve as the senior leader responsible for advancing utilization management across a growing healthcare organization. This executive will establish an enterprise UM strategy spanning medical necessity, authorization, denial prevention, reimbursement optimization and patient progression while strengthening standardization, analytics and technology across a geographically dispersed organization. The role will also assess the future state operating model, develop the existing UM leadership team and build strong partnerships with hospital and clinical leadership to position UM as a strategic clinical and financial discipline.
The ideal candidate will bring 10+ years of progressive healthcare experience with significant leadership responsibility in utilization management, utilization review, medical management, care management or a related function. They will combine clinical and payer expertise with a strong understanding of hospital operations, medical necessity, documentation and reimbursement performance, ideally across a multi-facility environment. Behavioral health experience is preferred but not required, while experience across both payer and provider settings is particularly attractive. The successful candidate will be a data-driven, technologically curious and hands-on leader who can translate operational opportunities into practical solutions while building credibility with physicians, hospital executives and experienced clinical teams.
