Children's National Hospital | Nurse Manager, Utilization Review

2 weeks ago

washington, United States Children's National Hospital Full time

This position will manage activities and staff of the Utilization Review and Clinical Documentation Improvement departments.


  • Supervise and evaluate the daily work of these teams in accordance with departmental and organizational policies.
  • Provide education within the departments and the organization at large on clinical care, levels of care, and financial issues.
  • Analyze and report data related to case management activities, payer activities, resource utilization, and clinical denials.
  • Lead hospital wide initiatives on behalf of the department.
  • Monitor the performance, collection and analysis of data to report on the effectiveness of process improvement to the organization and department.
  • Participate in the planning, development and implementation, and ongoing success of the Clinical Documentation Management Program.
  • Educate members of the patient care team regarding documentation guidelines, including attending physicians, nursing, and other interdisciplinary team members.


Minimum Education

  • Master's Degree (Required)


Minimum Work Experience

  • 7 years Healthcare experience (Required)
  • 3 years Supervisory experience (Required)


Required Licenses and Certifications

  • Registered Nurse in District of Columbia (Required)Basic Life Support for Healthcare Provider (BLS) (Required)
  • CCDS or CDIP (Preferred)
  • Case Management Certification (CCM or CMSA) (Preferred)

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