Director of Utilization Review

2 weeks ago


Miramar, Florida, United States Memorial Healthcare System Full time

Job Summary:

We are seeking a highly skilled and experienced Director of Utilization Review to join our team at Memorial Healthcare System. As a key member of our leadership team, you will be responsible for directing the department's activities and resources to ensure alignment with our mission, values, and objectives.

Key Responsibilities:

  • Prepares and evaluates departmental budgets, ensuring compliance with allocated funding.
  • Coordinates and directs internal/external audits.
  • Plans and monitors staffing activities, including hiring, orienting, evaluating, disciplinary actions, and continuing education initiatives.
  • Manages and evaluates department operations, including information technologies, service level determination, and complaint management, to achieve performance and quality control objectives.
  • Develops and implements departmental goals, plans, and standards consistent with clinical, administrative, legal, and ethical requirements.
  • Collaborates with other disciplines, physician liaison, and facility Directors of Clinical Effectiveness to ensure timely, accurate, and compliant utilization review.

Requirements:

  • Accredited Program: Nursing (Required)
  • Registered Nurse License (RN LICENSE) - State of Florida (FL)

Working Conditions and Physical Requirements:

  • Bending and Stooping = 60%
  • Keyboard Entry = 80%
  • Kneeling = 40%
  • Lifting or Carrying 0 - 25 lbs Non-Patient = 60%
  • Pushing or Pulling 0 - 25 lbs Non-Patient = 60%
  • Reaching = 60%
  • Repititive Movement Hand/Arm = 80%
  • Sitting = 80%
  • Standing = 80%
  • Walking = 80%
  • Audible Speech = 80%
  • Hearing Acuity = 80%
  • Distinguish Color = 80%
  • Seeing - Far = 80%
  • Seeing - Near = 80%

Shift:

Primarily for office workers - not eligible for shift differential

Disclaimer: This job description is not intended, nor should it be construed to be an exhaustive list of all responsibilities, skills, efforts or working conditions associated with the job. It is intended to indicate the general nature and level of work performed by employees within this classification.



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