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)
A rewarding opportunity is now available in the American Southwest for the RN Director Case Management! The outstanding hospital leadership team is seeking an energetic and motivated case management nurse leader with a go-getter attitude.
Reporting directly to the Chief Financial Officer CFO, the Case Management Nurse Director will become responsible for autonomous oversight of the Case Management program for this rapidly growing short term acute care hospital. The Case Management RN Director will provide their clinical background, knowledge, and expertise, guiding fellow healthcare leaders and Case Management staff to facilitate care coordination, discharge planning, medical necessity and clinical reviews, and assessment of proper utilization of resources. This role will also become responsible for facility-wide adherence to Centers for Medicare and Medicaid Services' Conditions of Participation, in addition to other regulatory and accreditation requirements. The RN Director Case Management will have the opportunity to oversee a hardworking team of RNs, Social Workers, and ancillary personnel who are prepared to support the leader in this crucial role.
Requirements for the Case Management Nurse Director role will include:
Located in the beautiful American Southwest, this award-winning 100 bed community hospital offers a variety of medical services, including: 24/7 Emergency Services, Inpatient and Outpatient Surgical Services, Advanced Cardiovascular Services, Medical Surgical Care, Intensive Care Services, as well as a broad range of Outpatient Services. This growing academic hospital has achieved accreditation by The Joint Commission and is well-known for its delivery of high quality care to patients in the local area and beyond.
This hospital is situated in a lush desert, known for its plentiful sunshine, amazing local Tex-Mex cuisine, and variety of fun outdoor activities. The Case Management Nurse Director will also find this area to provide affordable housing options and a great public school district, making this a great place to raise a family.
The RN Director Case Management will be offered a desirable salary, comprehensive benefits package, and potential relocation assistance. This is an excellent opportunity for the experienced Case Management nurse leader who is looking to take the next step with a growing healthcare organization!
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0 Utilization Management Director jobs found in El Paso, TX area