Utilization Management Director leads and directs the utilization review staff and function for a healthcare facility. Determines policies and procedures that incorporate best practices and ensure effective utilization reviews. Being a Utilization Management Director manages and monitors both concurrent reviews to ensure that the patient is getting the right care in a timely and cost-effective way and retrospective reviews after treatment has been completed. Provides analysis and reports of significant utilization trends, patterns, and impacts to resources. Additionally, Utilization Management Director consults with physicians and other professionals to develop improved utilization of effective and appropriate services. Requires a master's degree. Typically reports to top management. Typically requires Registered Nurse(RN). The Utilization Management Director manages a departmental sub-function within a broader departmental function. Creates functional strategies and specific objectives for the sub-function and develops budgets/policies/procedures to support the functional infrastructure. Deep knowledge of the managed sub-function and solid knowledge of the overall departmental function. To be a Utilization Management Director typically requires 5+ years of managerial experience. (Copyright 2024 Salary.com)
Location | US-CA-Redding | ID | 2024-156421 | Category | Clinical Professional | Position Type | Full Time | Shift | Days | Job Type | Non-Exempt |
Join an award-winning team of dedicated professionals committed to our core values of quality, compassion and community! Shasta Regional Medical Center, a member of Prime Healthcare, offers incredible opportunities to expand your horizons and be part of a community dedicated to making a difference.
Shasta Regional Medical Center is a 226-bed acute care facility serving Northern California. The hospital offers a comprehensive range of services. Shasta Regional Medical Center is one of the nation's 50 Top Cardiovascular Hospitals recognized by Watson Health and holds an 'A' Grade from Leapfrog Group, the nation's premier advocate of transparency in health care.The hospital is Joint Commission Certified for Stroke, Hip/Knee and Diabetes. They are a Five Star recipient for treatment of heart failure, respiratory failure and is named among the top 5% in the nation for patient safety. Shasta Regional Medical Center delivers patient-centered healthcare with compassion, dignity and respect for every patient and their family. For more information, visit www.shastaregional.com.
We are an Equal Opportunity Employer and do not discriminate against applicants due to veteran status, disability, race, gender, gender identity, sexual orientation, or other protected characteristics. If you need special accommodation for the application process, please contact Human Resources. Know Your Rights: https://www.eeoc.gov/sites/default/files/2022-10/EEOC_KnowYourRights_screen_reader_10_20.pdf
SOCIAL SERVICE II: To provide emotional support, crisis intervention and counseling for Pediatrics, Adolescents, Adults, Older Adults and their significant others to cope with a multiplicity of social and emotional problems; information and referral; referrals for financial assistance and supportive services to patients and families with problems that are related to treatment services, illness, disability or trauma. To provide case management & milieu management, complete psychosocial assessments, assist in the development and re-evaluation of Treatment Plans and work as a member of an interdisciplinary team, and to coordinate discharge planning. Complete necessary documentation and maintain clinical record for each client during their length of stay.
EDUCATION, EXPERIENCE, TRAINING
1. Master's degree in Social Work, Marriage and Family Therapy, Licensed Professional Clinical Counselor or related field.
2. In states requiring license, required upon hire and maintain current in accordance with state regulations. In states without a licensure requirement, current registration for with appropriate state board required and/or under clinical supervision to meet clinical hours required for licensure.
3. Current BLS certificate upon hire and maintain current.
4. Minimum one (1) year Inpatient l or Outpatient Behavioral Health experience. Experience in working with a diverse population with a wide range of problems (i.e., death and dying, maternal and child care, substance abuse, disability, chronic illness, etc.).
Shasta Regional Medical Center offers competitive compensation and a comprehensive benefits package that provides employees the flexibility to tailor benefits according to their individual needs. Our Total Rewards package includes, but is not limited to, paid time off, a 401K retirement plan, medical, dental, and vision coverage, tuition reimbursement, and many more voluntary benefit options. A reasonable compensation estimate for this role, which includes estimated wages, benefits, and other forms of compensation, is $26.50 to $40.53. The exact starting compensation to be offered will be determined at the time of selecting an applicant for hire, in which a wide range of factors will be considered, including but not limited to, skillset, years of applicable experience, education, credentials and licensure.
0 Utilization Management Director jobs found in Chico, CA area