Utilization Management Director jobs in Kingsport, TN

A wonderful, privately-owned long-term care facility is actively seeking an experienced & knowledgeable Director of Risk Management.

Located in Kingsport, TN

Salary ranges UP to $75K

Duties/Responsibilities:
• Evaluates regulatory compliance and develops, plans, and implements processes to maintain regulatory compliance within the facility. Directs regulatory compliance within the facility to maintain compliance and continuous quality improvement with Federal, State, and local regulations, the accepted standard of care, and established facility policies and procedures.
• Spearheads survey management including continuous/ongoing preparation for regulatory visits, assists management during regulatory visits, participates in the development of plans of correction and the monitoring of compliance with plans of correction, and ongoing compliance with process changes related to plans of correction.
• Plans, develops, organizes, implements, evaluates, and directs the facility Quality Assurance and Performance Improvement Plan and Program. Leads QAPI Meetings in conjunction with the Administrator and maintains QAPI Minutes and reports from facility departments. In conjunction with the Administrator, Director of Nursing Services and other Department heads, evaluates the facilities performance indicators and establishes a system to monitor them to promote improvements, enhance resident care, maintain regulatory compliance, and promote resident satisfaction. Participates in the facility assessment to identify facility needs, opportunities for improvement, and potential opportunities for program expansion and to identify training requirements needed to care for residents in the facility.
•Evaluates current training programs to ensure they meet the needs of residents in the facility and complies with regulatory requirements and develops and implements training plans to meet the needs of all residents. Oversees the financial management of the Clinical services Department.
•With the Administrator and Director of Nursing Services, develops staffing and budgetary plans for the Nursing Services Department. Oversees and assists in the scheduling of nursing staff in the facility to ensure resident needs, regulatory and budget standards are met. Educates staff on new and revised policies and procedures, and monitors staff practices to maintain regulatory compliance. Participates in daily or weekly management team meetings to discuss census changes, resident changes in status, complaints, or concerns. Facilitates, serves, attends, or participates in various committees of the facility as appointed. Ensures adequate staff coverage on the units, general cleanliness, and maintaining optimal resident functions.
•Collaborates with members of the interdisciplinary team, physicians, consultants, and community agencies to identify and resolve issues and improve the quality of services. Participates in the recruitment, hiring, and termination of nursing personnel. Performs rounds to observe residents and ensure nursing needs are being met. Conducts observations of nursing care and develops education to ensure nursing staff is competent in current knowledge and skills required to care for residents in the facility. Promotes teamwork, mutual respect, and effective communication.
•Monitors the infection control program with the Infection Preventionist to maintain compliance with current infection control guidelines to prevent the development and transmission of disease and infection. Participates in budget development for the nursing department, medical, nursing, and central supplies with input from the Director of Nursing Services. Oversees resident incidents and concerns daily to identify any unusual occurrences and reports them promptly to the Administrator and/or state agency for appropriate action. Monitors for allegations of potential abuse or neglect, or misappropriation of resident property and participates in the investigative process. Promotes safe work practices, safety rules, and accident prevention procedures to prevent employee injury and illness.

Qualifications:
•Excellent oral communication and interpersonal skills to interact positively with staff, patients and patients’ families. Extensive knowledge of nursing best practices and federal, state and local healthcare laws
•Strong written communication skills to compile reports and write evaluation

•Must have TN RN license and long term care experience

•Analytical skills to interpret diagnostic information and financial data
•Time management and multitasking skills to complete many tasks throughout the day
•Problem-solving skills to overcome obstacles in delivering patient care
•Ability to use electronic health records, word processing, spreadsheet and email software

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