Strategic Utilization Director
3 weeks ago
Job Summary:
The Director of Care Optimization will be responsible for the strategic direction setting, management, and continuous improvement of the Utilization and Case Management Services Unit at University Hospital in Newark, NJ.
This role evaluates the efficiency, appropriateness, and necessity of medical services, procedures, and level of care for patients. The Director will develop and implement strategies to improve workflows and processes/procedures to enhance the utilization review program.
The ideal candidate will have a strong orientation to customer satisfaction, effective teamwork, problem-solving, and conflict management. A Bachelor's Degree in Nursing is required, and a Master's Degree is preferred. The candidate must be licensed as a Registered Nurse in the State of New Jersey and have at least five years of experience in an acute care setting, including two years in utilization review/case management/quality improvement leadership.
Key Responsibilities:
- Evaluate medical services, procedures, and level of care for patients
- Develop and implement strategies to improve workflows and processes/procedures
- Ensure care is delivered to patients in appropriate time frames to maximize patient flow and reimbursement
- Provide decision support to patients, families, and physicians
- Support the mission of University Hospital
Qualifications:
- Licensed as a Registered Nurse in the State of New Jersey
- Bachelor's Degree in Nursing required, Master's Degree preferred
- At least five years of experience in an acute care setting, including two years in utilization review/case management/quality improvement leadership
- Excellent interpersonal, communication, and problem-solving skills
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