Manager Utilization Review
Manager Utilization Review
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Job Description
At Mass General Brigham we know it takes a surprising range of talented professionals to advance our missionfrom doctors nurses business people and tech experts to dedicated researchers and systems analysts. As a notforprofit organization Mass General Brigham is committed to supporting patient care research teaching and service to the community. We place great value on being a diverse equitable and inclusive organization as we aim to reflect the diversity of the patients we serve.
At Mass General Brigham we believe a diverse set of backgrounds and lived experiences makes us stronger by challenging our assumptions with new perspectives that can drive revolutionary discoveries in medical innovations in research and patient care. Therefore we invite and welcome applicants from traditionally underrepresented groups in healthcare people of color people with disabilities LGBTQ community and/or gender expansive first and secondgeneration immigrants veterans and people from different socioeconomic backgrounds to apply.
Job Summary
The Manager of Utilization Review is accountable for the delivery of consistent highquality patient care promoting the development and satisfaction of Utilization Review nurses and support staff providing operational efficiencies and insuring compliance with hospital and utilization management regulatory policies and standards of practice. The Manager of Utilization Review develops and implements department initiatives to enhance the evolving role of the Utilization Management.The Manager of Utilization Review provides leadership across multiple hospitals within the system. The role ensures patientfocused Utilization Management standards of practice personnel management and development and fiscal responsibility. In addition to daily operations the role maintains and cultivates partnerships with numerous clinical and nonclinical services/departments within the organization through participation in Case Management Revenue Cycle Contracting and MGB Payer groups committees and initiatives.
Qualifications
Qualifications:
Bachelors Degree in Nursing required Masters Degree in Nursing or Social Work preferred. Registered Nurse RN State License
35 years utilization review experience required
23 years leadership experience required
Knowledge Skills and Abilities:
Excellent team communication skills.
Strong interpersonal skills with the ability to develop motivate and inspire a team.
Strong team player that is able to multitask with multiple interruptions in a deadlineintense environment.
Identifying complex problems and reviewing related information to develop and evaluate options and implement solutions.
Understanding the implications of new information for both current and future problemsolving and decisionmaking.
Additional Job Details (if applicable)
Remote Type
Work Location
Scheduled Weekly Hours
Employee Type
Work Shift
EEO Statement:
Mass General Brigham Competency Framework
At Mass General Brigham our competency framework defines what effective leadership looks like by specifying which behaviors are most critical for successful performance at each job level. The framework is comprised of ten competencies (half PeopleFocused half PerformanceFocused) and are defined by observable and measurable skills and behaviors that contribute to workplace effectiveness and career success. These competencies are used to evaluate performance make hiring decisions identify development needs mobilize employees across our system and establish a strong talent pipeline.
Required Experience:
Manager
Employment Type
Full-Time
