Utilization Review Manager / RN
Utilization Review Manager / RN
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1 Vacancy
Job Description
Overview
Be rewarded. Belong. At Emory Healthcare.
At Emory Healthcare we fuel your professional journey with better benefits valuable resources ongoing mentorship and leadership programs for all types of jobs and a supportive environment that enables you to reach new heights in your career and be what you want to be.
We provide:
- Comprehensive health benefits that start day 1
- Student Loan Repayment Assistance & Reimbursement Programs
- Family-focused benefits
- Wellness incentives
- Ongoing mentorship development and leadership programs
- And more
Description
The Utilization Review Manager is responsible for direct oversight of the daily operations of the UR Department.
- The UR Manager will ensure departmental day to day operations are successful by creating schedules arranging coverage and dividing work as necessary in order to ensure work is completed in a timely manner which will ensure compliance with the Utilization Review Plan and regulatory/compliance guidelines.
- The UR Manager is responsible for maintaining managing and processes and procedures as it relates to day to day workflow.
- The UR Manager will be responsible for collaborating with Case Management/Utilization Review Leadership in order to successfully implement new policies and procedures.
- The UR Manager is responsible for identifying opportunities for improvement in workflows/processes as well as working through resolution when such things are identified.
- The UR Manager will ensure the department is compliant by ensuring the team adheres to established policies and procedures.
- The UR Manager will ensure Case Management systems and tools are being utilized as designed including staying up to date with system updates and upgrades.
- The UR Manager will consistently monitor quality and productivity standards in order to manage individual performance as well as the teams overall performance.
- The UR Manager will understand key performance indicators for the Utilization Review Department and be actively working with their teams to achieve them.
- The UR Manager will be transparent in sharing performance-based metrics with their teams and have accountability to those metrics.
MINIMUM QUALIFICATIONS: - Must have a valid active unencumbered Nursing license or temporary permit approved by the Georgia Licensing Board.
- Bachelors degree in nursing required but Masters degree in nursing or related field preferred.
- 3 years experience in Case Management (CM) required. 3 years healthcare experience required. Case Management certification preferred.
- Leadership experience preferred. Proven ability to coach mentor and lead. Demonstrates leadership abilities
Additional Details
Emory is an equal opportunity employer and qualified applicants will receive consideration for employment without regard to race color religion sex national origin disability protected veteran status or other characteristics protected by state or federal law.
Emory Healthcare is committed to providing reasonable accommodations to qualified individuals with disabilities upon request. Please contact Emory Healthcares Human Resources at . Please note that one weeks advance notice is preferred.
Required Experience:
Manager
Employment Type
Full-Time
