Regional Claims Manager jobs in Everett, WA

The information described in this job description has been designed to indicate the general nature of the work performed. It is not designed to contain or be interpreted as a comprehensive inventory of all duties, responsibilities and qualifications required of employees assigned to this job.

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Job Summary
This position manages clinical practices and technology to support the delivery of patient-centered care. The Surgical Services department includes the ORs, PACU, Surgical Care Unit, Preadmission Testing, Anesthesia Services and Sterile Processing. This position cultivates trusting relationships between surgeons, anesthesia providers, staff and hospital administration. Responsibility includes the ongoing clinical and business development of the service line, promoting competitive growth. The position collaborates with other clinical areas within Skagit Regional Health to ensure exceptional clinical outcomes, preserving an outstanding patient experience. This position serves as a role model for the advancement of OR Nursing and professional practice.

Essential Functions
Collaborates and establishes key relationships with surgeons, anesthesia providers, service line team members and administrative staff to plan, assess and revise goals and strategies related to business development and cost management. Participates in short and long-term planning for the surgical service line. Participates in SRH system-wide initiatives related to safety, courtesy, patient satisfaction, employee expertise and engagement, and efficiency. In conjunction with the Regional Director and Business Manager, creates and manages a successful operational, productivity and capital budget that is developed with strong business instincts for growth, quality and financial performance. Operates the service line toward greater efficiency in scheduling, turnaround time, supply costs and labor management, championing continuous performance improvement and Lean processes. Integrates service line with SRH structures by working cooperatively with department leaders to design a coordinated service for patients and families. Oversees the clinical education for new and current OR staff. Develops and ensures compliance with procedural protocols, including Universal Protocols and other consistent standard operating procedures. Promotes staff engagement, ensures accountability among staff and operates as a visible leader for the department and SRH. Ensures compliance with productivity standards and staffing guidelines per AORN, SGNA, and ASPAN. In conjunction with Quality, ensures that infection prevention standards met in all units per AAMI, DOH, CMS and other relevant regulatory guidelines. Assists Regional Director in meeting the requirements/standards of DNV and other accrediting and regulatory bodies. Works with Director for monitoring and improving the quality of services provided in surgical services. Attends section and medical staff meetings. Actively aligns operations to support Key Performance Metrics. Has responsibility for development and implementation and ongoing evaluation of CQI studies in the department with the support of the Regional Director and Quality Management. In collaboration with Human Resource and the Regional Director, determines appropriate staff counseling and corrective action as needed. Supports and promotes SRH Mission and Values. Performs other duties as assigned by Regional Director or designee.

Education
Bachelor's Degree Nursing required. Master's degree highly preferred.

Experience/Training
Requires a minimum of five (5) years’ experience as an RN in Surgical Services (ie; Operating Room, Endoscopy, Perianesthesia), including leadership experience.

License/Certifications
Current Washington State RN licensure required. Current American Heart Association (AHA) BLS certification required. Certification in area of clinical expertise required within 6 months of hire.

Other Skills
Excellent interpersonal, written and verbal communication skills; ability to communicate effectively with physicians, nursing personnel, other healthcare professionals, patients and visitors. Must have strong intermediate computer/keyboard skills and functional knowledge of Microsoft Office suite.

Physical Demands and Work Environment
The physical demands described here are representative of those that must be met by an employee to successfully perform the essential functions of this job. While performing the duties of this job, the employee is regularly required to talk and hear. This position is very active and requires standing, walking, bending, kneeling, stooping, crouching, crawling, and climbing all day. The employee must frequently lift or move objects and patients weighing over 50 pounds. Specific vision abilities required by this job include close vision, distance vision, color vision, peripheral vision, depth perception and ability to focus.Skagit Regional Health offers a comprehensive benefit package including medical, dental, vision, 457b/401a (retirement), long term disability, and paid time off to all employees holding an FTE of 20 or more hours per week. Eligible employees also receive sick time pay.