Division Director Utilization Management, Florida

Overview:
Be part of a nationally recognized health system where leadership drives excellence in patient care.

UF Health Central Florida is seeking a results-oriented and strategic leader to serve as Division Director of Utilization Management. This role plays a critical part in optimizing resource use, improving clinical outcomes, and supporting systemwide initiatives focused on quality, compliance, and performance. The Division Director will oversee utilization management operations and lead a team dedicated to appropriate care coordination and patient status determinations, while collaborating with clinical, financial, and administrative partners across the organization.

Responsibilities:
Lead and manage the Utilization Management department, including hiring, training, coaching, and retaining a high-performing team.

Oversee development and implementation of methodologies to enhance program effectiveness and ensure compliance with payor and regulatory guidelines.

Establish and monitor performance metrics to assess efficiency, accuracy of patient status assignments, and outcomes.

Collaborate with physician advisors, care teams, and revenue cycle leadership to reduce denials, optimize LOS (length of stay), and support accurate documentation.

Maintain accountability for department financials, productivity, staffing levels, and budgetary outcomes.

Participate in quality improvement efforts and VHA Care Coordination initiatives.

Act as a liaison to regulatory agencies and ensure timely reporting and response to audits or denials.

Foster a positive, professional, and patient-centered culture aligned with UF Health's mission and hospitality standards.

Qualifications:
Education:

Bachelor’s degree required

Master’s degree preferred

Licensure:

Current Registered Nurse (RN) license required

Experience:

Proven leadership and/or management experience in utilization management or case management in a hospital or health system setting

Strong knowledge of clinical care coordination, level of care criteria, healthcare regulations, and managed care

Key Competencies:

Strong financial acumen and ability to use data to guide decisions

Excellent communication and interpersonal skills

Results-driven, adaptable, and skilled in leading through change

Demonstrated ability to coach, mentor, and build highly engaged teams

Commitment to patient safety, service excellence, and continuous improvement