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)
Description
PeaceHealth is seeking a RN Utilization Review/Case Management - Behavioral Health for a Per Diem/Relief, 0.00 FTE, Day position. The general salary range for this job opening at PeaceHealth is $41.20 – $61.80. The actual hiring rate is dependent upon several factors, including but not limited to, the job/position responsibilities, location, terms of the applicable collective bargaining agreement, education, training, work experience, seniority, work performance, etc.
Enjoy metropolitan amenities with a small-town feel in Eugene-Springfield! Located between the Cascade mountains and the Pacific Ocean the area offers an adventure-driven community with spectacular waterfalls, stunning beaches, world-class ski slopes, crystalline rivers and miles of scenic bike paths in your backyard. Don't forget your hiking boots!
CultureHQ.com - A Better Workplace CommunityResponsible for promoting effective utilization and monitoring of healthcare resources, along with medical case management of patients with chronic unstable conditions and patients who have been recently hospitalized. This position will assume a leadership role with the interdisciplinary team to achieve optimal clinical, financial, and satisfaction outcomes.
Details of the position:
What you bring:
PeaceHealth is committed to the overall wellbeing of our caregivers. The benefits included in positions less than 0.5 FTE are 403b retirement plan for caregiver contributions; wellness benefits, discount program, and expanded EAP and mental health program.
For a full description or questions about the position, contact Melissa, [email protected]
See how PeaceHealth is committed to Inclusivity, Respect for Diversity and Cultural Humility.
For full consideration of your skills and abilities, please attach a current resume with your application. EEO Affirmative Action Employer/Vets/Disabled in accordance with applicable local, state or federal laws.
PeaceHealth requires a completed Primary Vaccine Series (e.g., 2 dose monovalent Pfizer, Moderna or Novavax series or 1 dose J&J vaccine series) or be Up to Date (receiving the most recent Pfizer/Moderna bivalent vaccine/booster) for COVID-19 vaccination prior to their start date. PeaceHealth has a medical and religious exemption request process for those that are unable to receive the COVID-19 primary vaccine series due to medical/religious reasons. For caregivers that will be working in Oregon there is a personal vaccine exemption form that may be requested.
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