Mgr Utilization Review RN

·
Full time
Location: Dover
· ·
About Us Here at Baylor Scott & White Health we promote the well-being of all individuals, families, and communities. Baylor Scott and White is the largest not-for-profit healthcare system in Texas that empowers you to live well. Our Core Values are: We serve faithfully by doing what's right with a joyful heart. We never settle by constantly striving for better. We are in it together by supporting one another and those we serve. We make an impact by taking initiative and delivering exceptional experience. Benefits Our competitive benefits package empowers you to live well and provides: Eligibility on day 1 for all benefits Dollar-for-dollar 401(k) match, up to 5% Debt-free tuition assistance, offering access to many no-cost and low-cost degrees, certificates and more Immediate access to time off benefits At Baylor Scott & White Health, your well-being is our top priority. Note: Benefits may vary based on position type and/or level Job Summary As a Manager for Utilization Review, you guide and supervise staff. You oversee care coordination across all business areas. You help manage patients and speed up care transitions. You assess programs and improve them. You evaluate workflow and system design to meet requirements. Salary The pay range for this position is $47.05 (entry-level qualifications) - $72.93 (highly experienced). The specific rate will depend upon the successful candidate’s specific qualifications and prior experience. Essential Functions of the Role Manage Care Coordination operations daily, including supervision of staff, resource management, and budget control. Departments involved are Utilization Management, Case Management, and Disease Management. Ensure all regulations, policies and procedures of the division are strictly adhered to during daily operations. Partner with both internal and external teams to guarantee top-notch service for all stakeholders, including members and providers. Develop a comprehensive knowledge of the medical management system, which involves in-depth understanding of the system configuration. Assess system changes' impact, configure as needed, document changes carefully, and track changes to meet requirements. Continuously improve policies, procedures, resources. Regularly audit and train to meet business goals effectively. Partner with teams for good care, lower costs. Move patients quickly through care levels for better outcomes. Manage continuing care for all members, focusing on case management for specific populations and members. Key Success Factors Demonstrable knowledge in discharge planning, case management, utilization review and different care levels. Outstanding written and verbal communication skills, which are maintained professionally in all interactions. An expertise of healthcare systems and healthcare plans. Capability to adjust to changes in the medical management system and assess their impact in meeting regulatory and business requirements. Skills in operational decision-making about work processes including quality and productivity standards, setting clear goals for employees and project teams. Ability to align resource allocation recommendations with broader goals for effective scheduling and goal realization. Proficiency in making effective recruitment and termination recommendations. Capacity to evaluate and propose changes to policies and implement procedures that influence the managed organization. Understanding business operations involves planning, goal setting, budgeting, employee compensation, risk management, and compliance activities. Familiarity with general computer applications like Microsoft Office, information security software, scheduling and payroll systems, email, and electronic medical documentation. Belonging Statement We believe that all people should feel welcomed, valued and supported, and that our workforce should be reflective of the communities we serve. Qualifications Possess a Bachelor's degree Have at least five years of relevant work experience Hold a valid registration as a Registered Nurse As a health care system committed to improving the health of those we serve, we are asking our employees to model the same behaviours that we promote to our patients. As of January 1, 2012, Baylor Scott & White Health no longer hires individuals who use nicotine products. We are an equal opportunity employer committed to ensuring a diverse workforce. All qualified applicants will receive consideration for employment without regard to race, color, religion, sex, national origin, disability status, protected veteran status, or any other characteristic protected by law.

#J-18808-Ljbffr

Recent Jobs

London (On site) · Full time

Are you a smart, driven professional who takes pride in making a difference in local communities? Turner & Townsend’s Real Estate division is experiencing significant growth and we’re looking for an experienced industry professional with health project experience to join our high-performing and collaborative Project Management team. Why Join Us? Impactful Work: Contribute to social [...]Read More... from Assistant Project Manager – Healthcare See details

Chasetown (On site) · Full time

My client, Autosmart International are a manufacturing success story! Site Operations Manager – leading fast-paced manufacturing and warehousing About Our Client Autosmart International is a manufacturing success story, leading the field in vehicle cleaning products. We are the No.1 choice of automotive trade customers across the UK. We have doubled in size in the last [...]Read More... from Site Operations Manager See details

London (On site) · Full time

CSS are looking for an experienced duty officer to join our client’s team who are a local council responsible for all areas within the Tendering district. Working hours: All shifts are 8 hours long with various start times available: Monday to Friday – start times between 6AM – 3PM Saturday & Sunday – 6AM – [...]Read More... from Duty Officer See details