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Executive Director of Utilization Management
Company: Vanderbilt Health
Location: Nashville, TN
Employment Type: Full Time
Date Posted: 01/21/2021
Expire Date: 02/20/2021
Job Categories: Computers, Software, Customer Service and Call Center, Finance/Economics, Financial Services, Healthcare, Practitioner and Technician, Information Technology, Installation, Maintenance, and Repair, Insurance, Internet/E-Commerce, Counseling, Quality Control, Research & Development, Medical, Web Technology
Job Description
Executive Director of Utilization Management

Executive Director of Utilization Management 

Vanderbilt University Medical Center Executive Search Team is conducting a national search for a  strong experienced leader for our  Executive Director, Utilization Management. This role requires extensive Utilization Management experience, Revenue Cycle and a background that includes strategic process improvements and verifiable results in a large scale medical center.

Position Summary:

In this role the Executive Director of Utilization Management must be a strategic change leader and possess specific experience leading change within Utilization Management, Revenue Cycle and Case Management. The Executive Director will provide overall leadership by developing goals, objectives, policies and procedures, change management, process improvement and a clear vision for best practices. The  Executive Director position will supervise/lead the Utilization Management department. The Utilization Management department will integrate with the Revenue Cycle Department effective 8/1/2020. This position will report to Revenue Cycle and oversee the activities of 25 FTEs.


Department Summary:

Patient Financial Services consists of approximately 250 staff located in Nashville and approximately 150 supplemental staff who provide support in five primary service areas, all of which are critical to the success of the Revenue Cycle. The five primary service areas include:

  • Central Registration and Insurance Management
  • Financial Clearance
  • Pre-Service Collections, Financial Counseling, and Outpatient Referral Assistance
  • Patient Liability and Customer Service
  • VUH/VCH Admitting and VUH/VCH ED Registration/Discharge

Patient Financial Services was created in September 2014 to provide one leadership structure to manage the above mentioned service areas for hospital and physician billing and collections. The service areas were located in multiple sites across Nashville until November 2015 when approximately 150 staff and management moved to newly renovated space in the Green Hills Office Building.Patient Financial Services plays a critical role in the revenue cycle as these teams are involved in both front and back-end processes, allowing them to enhance the patient experience while striving to maximize revenue and accelerate cash collection. This team works closely with Patient Care Centers, Access Centers, and Contracting to serve as a resource and provide timely education on new initiatives and improved processes.

Position Shift: 

Days; exempt 


Discover Vanderbilt University Medical Center:

Located in Nashville, Tennessee, and operating at a global crossroads of teaching, discovery and patient care, VUMC is a community of individuals who come to work each day with the simple aim of changing the world. It is a place where your expertise will be valued, your knowledge expanded and your abilities challenged. It is a place where your diversity — of culture, thinking, learning and leading — is sought and celebrated. It is a place where employees know they are part of something that is bigger than themselves, take exceptional pride in their work and never settle for what was good enough yesterday. Vanderbilt’s mission is to advance health and wellness through preeminent programs in patient care, education, and research.

Our Nursing Philosophy:

We believe highly skilled and specialized nursing care is essential to Vanderbilt University Medical Center’s mission of quality in patient care, education and research. We believe nursing is an applied art and science focused on helping people, families and communities reach excellent health and well-being.


Achieve the Remarkable:

Learn more about VUMC Nursing:

·        Nursing Careers: http://www.vumcnursingcareers.com/index.html

·        Benefits: http://www.vumcnursingcareers.com/benefits.html

·        Our Nursing Philosophy: http://www.vumcnursingcareers.com/philosophy.html

·        Our Nursing Leadership: http://www.vumcnursingcareers.com/leadership.html

·        Shared Governance: http://www.vumcnursingcareers.com/shared-governance.html

·        Education & Professional Development: http://www.vumcnursingcareers.com/professional-development.html

·        Life In Nashville: http://www.vumcnursingcareers.com/nashville.html

VUMC Nursing: http://www.mc.vanderbilt.edu/root/vumc.php?site=vanderbilt-nursing


  • Develop goals and objectives for the department based on interpretation of institutional policy and goals.
  • Plan to achieve goals or establish priorities.
  • Help department understand, share and support the vision
  • Initiate changes in or develop new policies, procedures and/or methods.
  • Analyze long-range impact of decisions and plans.
  • Ensure the most effective operations of the department through program development, process improvement and coordination/integration of processes with other departments.
  • Design, implement, evaluate and market programs to maximize clinical outcomes, functional status, patient/customer satisfaction and reimbursement.
  • Standardize services, processes, resources, and practice to improve efficiency.
  • Supervision to include responsibility for planning, coordinating, and controlling the work and procedures; provide advice/consultation to staff regarding problems
  • Adjust work schedules or project priorities to meet emergencies or changing conditions
  • Participate on departmental and/or interdepartmental committees to address problems and facilitate information exchange about programs, problems, etc. Provide information to others (oral or written) to explain/clarify problems, issues or requests.
  • Participate in periodic management meetings to keep top management informed of department problems and concerns
  • Analyze and evaluate ongoing department programs to identify areas where adjustments/improvements are needed
  • Develop staffing plans to ensure developmental objectives are being met.
  • Define and achieve financial targets in support of business goals of the institution.
  • Prepare an annual operating budget for a unit or department, including direct labor, material and supplies, services, equipment maintenance and replacement
  • Present and justify a proposed budget (operating and capital expenditure) to a management review committee
  • Evaluate organizational functions and structures to best determine the allocation and utilization of resources
  • Analyze and evaluate budget variance to determine cause,
  • Prepare justification or develop alternatives for cost containment/reduction
  • Project future budgets based upon analysis of current operations.
  • Create and exceed service standards utilizing key service dimension and from knowledge of patient/customer expectations and best practice.
  • Establish service standards for the department and determine if service standards are compatible with financial targets.
  • Ensure that the service standards are met or exceeded by utilizing customer satisfaction, best practices and market information to improve customer service and satisfaction.
  • Create an organizational culture (both within and across departments) that provides a safe, satisfying and enriching environment for employees and provides a qualified, competent staff to meet patient needs.
  • Provide leadership to promulgate the mission and the values of the institution to the department.
  • Model behavior consistent with the mission, vision, and values of the enterprise through leading, coordinating projects, innovation, initiating improvement, and developing new programs.
  • Demonstrate a leadership style that is facilitative and collaborative.
  • Communicate within and across departments to maximize effectiveness, efficiently and information sharing.
  • Ensures all Human Resource and VUMC policies and procedures are followed according to standards.
  • Define the qualifications and performance expectations for all staff positions through the Performance Development system, including department specific job descriptions, measurable performance standards.
  • Create an environment that encourages and supports self-development and learning for all staff through regular feedback, by assuring the development of staff through orientation, training programs, work experiences and assessing competencies by meeting the performance expectations stated in his or her job description in a timely manner (normally annually).
  • Identify, establish and evaluate quality assurance standards, programs, and procedures within department.
  • Establish and evaluate standards of performance to ensure safe, effective, and efficient operation of the department.
  • Ensure that standards are met within area of responsibility to assure clinical enterprise accreditation/licensure.

Qualifications & Requirements

Bachelor's Degree (or equivalent experience) and 8 years experience

Licensure, Certification, and/or Registration (LCR):


RN Licensure Required 

Contact Information
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