RN Supervisor, Utilization Management
3 weeks ago
We are looking foran experienced RN Supervisor, Utilization Management seeking a permanent opportunity. Our client offers growth and an exciting workplace to join along with competitive salary rates and great benefits
For immediate consideration, Please submit your resume to: bchairez@medicatg.comPay: $77hr
Summary:
The Supervisor of Utilization Management (UM) RN is responsible for executing the day-to-day operations of the UM department, and monitoring the Care Management (CM) staff’s responsibilities and activities. This includes, but not limited to, ensuring proper staffing and coverage; monitoring and evaluating departmental operations to ensure optimal efficiency, productivity, and effectiveness; documenting and appropriately addressing excellence or deviations in work, departmental, and organizational expectations; and conducting intermittent and annual performance evaluations.
Qualifications:
1. Associate's Degree in Nursing required, Bachelor's Degree in Nursing preferred
2. Minimum of 5-7 years of acute/clinical care experience.
3. Minimum of 2 years experience in Case/Care/Utilization Management in an acute care or health plan setting4. Minimum of 3-4 years in a lead/supervisory experience
5. Experience and knowledge regarding the physical, mental, and social needs of the patients.
Licenses/Certifications Required:
1.Registered Nurse (RN) - Active, current and unrestricted California License
2.Certified Case Manager (CCM)
Responsibilities:
1.Ensures adequate/appropriate distributions of workforce, assignments and time off requests.
2.Monitors of staff's performance including productivity and compliance with regulatory requirements, compliance with policies. Identifies, communicates and coaches to improve staff performance. Develops tools, job aids, and workflows to optimize the process flow, performance and productivity of the UM team. Completes intermittent and annual staff evaluations.
3.Serves as the primary resource for all business-related questions/issues raised by staff; escalates to appropriate leader/team when necessary.
4.Recommends and implements process improvement measures to achieve department's performance measures outcomes and goals.
5.Plans and oversees UM activities according to model of care, program description and policy and procedures to provide timely, quality care and services to members.
6.Maintains all assigned reporting responsibilities, conducts regular audits to ensure compliance with community, industry and organizational standards including regulatory requirements. Serves as a super-user on electronic programs and systems used by the department.
7.Assists in the development of programs, workflows, tools, training materials, orientation checklists, and competency checklist necessary to meet educational needs. Trains new staff, remediation of seasoned staff and cross training as needed in specified business lines.
INDMED
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