Utilization Management Director jobs in Greenville, MS

Purpose of Your Job Position
The primary purpose of your job position is to plan, organize, develop, and direct the overall operation of our Nursing Department in accordance with current federal, state, and local standards, guidelines, and regulations that govern our facility, and as may be required by the Administrator and Medical Director, to ensure that the highest degree of quality care is maintained at all times.

Delegation of Authority
As Director of Nursing Services you are delegated the administrative authority, responsibility, and ac- countability necessary for carrying out your assigned duties. In the absence of the Medical Director, you are charged with carrying out the patient-care policies established by this facility.

Job Functions
Every effort has been made to identify the essential functions of this position. However, it in no way states or implies that these are the only duties you will be required to perform. The omission of specific statements of duties does not exclude them from the position if the work is similar, related, or is an es- sential function of the position.


Duties and Responsibilities
Administrative Functions
•    Plan, develop, organize, implement, evaluate, and direct the nursing services department as well as its programs and activities.
•    Maintain written policies and procedures that govern the day-to-day functions of the nursing service department and ensure that personnel comply with such policies and procedures.
•    Make written and oral reports/recommendations to the Administrator as necessary/required, concern- ing the operation of the nursing service department.
•    Assist in developing methods for coordinating nursing services with other patient services to ensure the continuity of the patients’ total regimen of care.
•    Ensure that all nursing service personnel are in compliance with their respective job descriptions.
•    Participate in the maintenance and implementation of the facility’s quality assurance program for the nursing service department.
•    Participate in facility surveys (inspections) made by authorized government agencies as requested by the Administrator.
•    Periodically review the patient’s written discharge plan. Participate in the planning of the patient’s writ- ten discharge plan as required.
•    Meet with the nursing staff, as well as support personnel, in planning the department’s services, pro- grams, and activities.
•    Interpret the department’s policies and procedures to personnel, patients, visitors, and government agencies as required.
•    Perform administrative duties such as admitting, discharging, and transferring patients, completing medical forms, reports, evaluations, studies, charting, including I & A forms, etc., as necessary.
Committee Functions
•    Serve on various committees and attend meetings of the facility (i.e., Infection Control, Policy Advi- sory, Pharmaceutical, Quality Assessment, etc.) as required.
•    Prepare written and/or oral reports of the nursing service programs and activities to submit to such committee(s) as directed.
•    Provide information to the Quality Assurance and Assessment Committee as requested.
•    Participate in developing the agenda for the Care Plan Committee meetings as necessary.
•    Participate in regularly scheduled reviews of the discharge plans and make such plans available to the Care Plan Committee as required or as may be necessary.
 
•    Implement recommendations from established committees as instructed by the Administrator.

Personnel Functions
•    Determine the staffing needs, and ensure that a sufficient number of licensed practical nurses and certi- fied nursing assistants are available for all shifts to ensure that quality care is maintained.
•    Develop work assignments, and scheduling for the nursing department.
•    Make daily rounds of the nursing service department to ensure that all nursing service personnel are performing their work assignments in accordance with acceptable nursing standards.
•    Ensure that established policies and procedures, including dress codes, are followed by all departmental personnel.
•    Review complaints and grievances made or filed by department personnel. Make appropriate reports to the Administrator as required or as may be necessary.
•    Develop and maintain a good working rapport with inter-department personnel, as well as other depart- ments within the facility to ensure that nursing services and activities can be adequately maintained to meet the needs of the patients.
•    Create and maintain an atmosphere of warmth, personal interest and positive emphasis, as well as a calm environment throughout the unit and shift.
•    Meet with your staff on a regularly scheduled basis to assist in identifying and correcting problem areas and/or to assist in the improvement of services.
•    Ensure that departmental disciplinary action is administered fairly.
•    Report occupational exposures to blood, body fluids, infectious materials, and hazardous chemicals in accordance with the facility’s policies and procedures governing accidents and incidents.
•    Interview prospective employees, hire new employees, maintain and carry out disciplinary programs, monitor attendance and job performance, carry out suspensions, and execute employment terminations for nursing department personnel.

Nursing Care Functions
•    Participate in the interviewing and selection of new patients, including PASARR screenings, providing the Administrator with a Nursing Assessment of the patient, and the department’s ability to meet his needs.
•    Greet newly admitted patients upon admission. Escort them to their rooms as necessary.
•    Make rounds a minimum of twice daily.
•    Ensure that attending physicians record and sign progress notes, physicians’ orders, etc., on a timely basis and in accordance with current regulations.
•    Consult with the patient, his/her family, and the patient’s physician in planning the patient’s care, treat- ment, rehabilitation, etc., as necessary.
•    Review nurses’ notes to ensure that they are informative and descriptive of the nursing care being pro- vided, that they reflect the patient’s response to the care, and that such care is provided in accordance with the patient’s wishes.
•    Provide direct nursing care as necessary.
•    Authorize the use of restraints when ordered by a physician as necessary and in accordance with our facilities policies and procedures.
•    Ensure that patients who are unable to call for help are checked frequently.
•    Meet with patients, and/or family members, as necessary.
Staff Development Functions
•    Participate in developing, planning, conducting, and scheduling in-service training classes that provide instructions on “how to do the job,” ensure a well-educated nursing service department, and meet OSHA guidelines for required annual in-services.
•    Conduct General and Nursing Departmental orientations for all new employees.
•    Attend and participate in continuing education programs designed to keep you abreast of changes in your profession, as well as to maintain your license on a current status.

Safety and Sanitation Functions
•    Ensure that an adequate supply of personal protective equipment is on hand and readily available to personnel who perform procedures that involve exposure to blood or body fluids.
•    Ensure that personnel follow established procedures for the use and disposal of personal protective equipment, and established safety regulations in the use of equipment and supplies.
•    Ensure that all nursing service personnel comply with established departmental policies and procedures.
•    Ensure that nursing service work areas (i.e., nurses’ stations, medicine preparation rooms, etc.) and pa-
 
tient care rooms, treatment areas, etc., are maintained in a clean and sanitary manner.
•    Ensure that nursing service personnel follow established hand-sanitizing procedures.
•    Ensure that nursing service personnel participate in and conduct all fire safety and disaster prepared- ness drills in a safe and professional manner.
•    Participate in the implementation, and maintenance of the infection control program for monitoring communicable and/or infectious diseases among the patients and personnel.
•    Ensure that nursing service personnel follow established infection control procedures when isolation precautions become necessary.
•    Participate in the development, implementation and maintenance of the procedures for reporting haz- ardous conditions or equipment.
•    Report missing/illegible labels and MSDSs to the safety officer or other designated person.

Equipment and Supply Functions
•    Recommend to the Administrator the equipment and supply needs of the department.
•    Ensure that an adequate stock level of medications, medical supplies, equipment, etc., is maintained on premises at all times to meet the needs of the patient, and that supplies are used efficiently to avoid waste.
•    Ensure that only trained and authorized personnel operate the nursing service department’s equip- ment, and that they do so in a safe manner.
•    Ensure that appropriate MSDSs are on file for hazardous chemicals used in the nursing service depart- ment.

Care Plan and Assessment Functions
•    Participate in the development of written preliminary and comprehensive assessments of the nursing needs of each patient that identifies the problems/needs of the patient, indicates the care to be given, goals to be accomplished, and which professional service is responsible for each element of care as necessary.
•    Encourage the patient to participate in the development and review of his/her care plan.
•    Review patient care plans for appropriate patient goals, problems, approaches, and revisions based on nursing needs.
•    Ensure that all personnel involved in providing care to the patient are aware of the patient’s care plan.
•    Ensure that nursing personnel refer to the patient’s care plan prior to administering daily care to the patient.
•    Review nurses’ notes to determine if the care plan is being followed.
•    Assist the Patient Assessment/Care Plan Coordinator in planning, scheduling, and revising the MDS, including the implementation of RAPs and Triggers.
•    Review patient’s medical and nursing treatments to ensure that they are provided in accordance with the patient’s care plan and wishes.

Budget and Planning Functions
•    Adhere to departmental budget as given.
•    Suggest budget/planning changes to Administrator for the department.

Patient Rights Functions
•    Maintain the confidentiality of all patient care information.
•    Monitor nursing care to ensure that all patients are treated fairly, and with kindness, dignity, and re- spect.
•    Ensure that all nursing care is provided in privacy and that nursing service personnel knock before entering the patient’s room.
•    Ensure that all nursing service personnel are knowledgeable of the patients’ responsibilities and rights including the right to refuse treatment, and adhere to all facility patient rights and privacy policies and procedures .
•    Review complaints and grievances made by the patient and make a written/oral report to the Director indicating what action(s) were taken to resolve the complaint or grievance. Follow facility’s established procedures.
•    Report and investigate all allegations of patient abuse and/or misappropriation
•    of patient property.
•    Ensure that nursing staff personnel honor the patient’s refusal of treatment request, and that such re-
 
quests are in accordance with the facility’s policies governing advance directives.

Working Conditions
•    Works in office area(s) as well as throughout the nursing service area (i.e., drug rooms, nurses’ sta- tions, patient rooms, etc.).
•    Moves intermittently during working hours.
•    Is subject to frequent interruptions from patients, personnel, visitors, government agencies/ personnel, etc., under all conditions and circumstances.
•    Is subject to hostile and emotionally upset patients, family members, personnel, and visitors.
•    Communicates with the medical staff, nursing personnel, and other department supervisors.
•    Works beyond normal working hours and on weekends and holidays when necessary, and is subject to call-back during emergency conditions (e.g., severe weather, evacuation, post-disaster, etc.).
•    Is involved in community/civic health matters/projects as appropriate.
•    Attends and participates in continuing educational programs.
•    Is subject to injury from falls, burns from equipment, odors, etc., throughout the work day, as well as reactions from dust, disinfectants, tobacco smoke, and other air contaminants.
•    Is subject to exposure to hazardous chemicals, infectious waste, diseases, conditions, etc., including
TB, Covid variants, AIDS and Hepatitis B viruses.
•    Maintains a liaison with the patients, their families, support departments, etc., to adequately plan for the patients’ needs.
Education
•    A four-year Nursing Degree from an accredited college or university is preferred.

Experience
•    Must have experience as a supervisor in a hospital, long-term care facility, or other related health care facility.
•    Must have training in rehabilitative and restorative nursing practices.

Specific Requirements
•    Must possess a current, unencumbered, active license to practice as an RN in Arkansas.
•    Must work full-time hours of 40-hours per week minimum as required by state and federal regulation.
•    Must be able to read, write, speak, and understand the English language.
•    Must possess the ability to make independent decisions when circumstances warrant such action.
•    Must possess the ability to deal patiently, tactfully, with a cheerful disposition and enthusiasm with personnel, patients, family members, visitors, government agencies/personnel, and the general pub- lic based on whatever maturity level at which they are currently functioning.
•    Must be knowledgeable of nursing and medical practices and procedures, as well as laws, regulations, and guidelines that pertain to long-term care.
•    Must possess leadership and supervisory ability and the willingness to work harmoniously with and supervise other personnel.
•    Must possess the ability to plan, organize, develop, implement, and interpret the programs, goals, objectives, policies and procedures, etc., that are necessary for providing quality care.
•    Must be able to relate information concerning a patient’s condition.
•    Must not pose a direct threat to the health or safety of other individuals in the workplace.
•    Must be willing to follow all company, state and regulatory policies related to Infection Control and Vaccination requirements.

Physical and Sensory Requirements
(With or Without the Aid of Mechanical Devices)
•    Must be able to move intermittently throughout the workday.
•    Must be able to speak and write the English language in an understandable manner.
•    Must be able to cope with the mental and emotional stress of the position due to relating to and working with the ill, disabled, elderly, emotionally upset, and, at times, hostile people.
•    Must be able to see and hear or use prosthetics that will enable these senses to function adequately
 
to ensure that the requirements of this
•    position can be fully met.
•    Must function independently, and have flexibility, personal integrity, and the ability to work effectively with patients, personnel, and support agencies.
•    Must meet the general health requirements set forth by the policies of this facility.
•    Must be able to push, pull, move, and/or lift a reasonable minimum of pounds to a reasonable height and be able to push, pull, move, and/or carry such weight a reasonable distance.
•    May be necessary to assist in the evacuation of patients during emergency situations.