Rn Mgr Utilization Mgmt

dstaff
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📍 Hanover📍 Hanover, MD, United States📍 MD📍 usFull time

About this role

Company Description

Hosp

 

Job Description

Rn Mgr Utilization Mgmt 

Hanover, MD





Exp 5-7 yrs

Deg Bach

Bonus


Job Description

 

Responsible for providing clinical supervision to a team responsible for coordinating member service, utilization, access, and concurrent review to ensure cost effective utilization of health, mental health, and substance abuse services. Primary duties may include, but are not limited to:

Manages and oversees team responsible in case finding and coordinating cases that involve comorbid conditions.

Coordinates service delivery to include member assessment of physical and psychological factors.

Partners with providers to establish short and long term goals that meet the members needs, functional abilities, and referral sources requirements.

Identifies members with potential for high risk complications.

Reviews benefit systems and cost benefit analysis.

Evaluates medical, mental health and substance abuse service for cost containment.

Hires, trains, coaches, counsels, and evaluates performance of direct reports.

 

Qualifications

 

Requires a BA/BS; 5 years of experience in Health Care Management; or any combination of education and experience, which would provide an equivalent background.

 

We need an aggressive UM manager quick with acute inpatient services including NICU, ICU, CCU and Transplants .

We need current high volume experience with Maryland hospitals, on straight medical conditions.

-Current unrestricted RN license in the state of Maryland required.

-Prior managed care or insurance experience preferred.  

-Computer literate - MS Word, Excel, Outlook

-Knowledge of Milliman or Interqual criteria preferred

-Prior experience managing clinical staff required.

IDEAL CANDIDATE

Requires a BA/BS; 5 years of experience in Health Care Management; or any combination of education and experience, which would provide an equivalent background.


Current unrestricted RN license in the state of Maryland required.


Prior managed care or insurance experience preferred.  


Computer literate - MS Word, Excel, Outlook


Knowledge of Milliman or Interqual criteria preferred


Prior experience managing clinical staff required.


Qualifications

Additional Information

All your information will be kept confidential according to EEO guidelines.

Direct Staffing Inc


Frequently Asked Questions

Is the salary disclosed for the Rn Mgr Utilization Mgmt position at dstaff?
The salary for this Rn Mgr Utilization Mgmt role at dstaff is not publicly listed. Click "Apply Now" to learn more about the compensation package on their official careers page.
Where is the Rn Mgr Utilization Mgmt position at dstaff located?
This Rn Mgr Utilization Mgmt role at dstaff is based in Hanover, Hanover, MD, United States, MD, us. The position is listed as on-site or hybrid. Check the full job description or apply directly to confirm the work arrangement.
Is the Rn Mgr Utilization Mgmt role at dstaff full-time or part-time?
This is listed as a Full time position. It is posted as a Rn Mgr Utilization Mgmt role at dstaff.
How do I apply for the Rn Mgr Utilization Mgmt position at dstaff?
Click the "Apply Now" button on this page. You will be redirected to dstaff's official application portal hosted on smartrecruiters where you can submit your application directly.
When was the Rn Mgr Utilization Mgmt job at dstaff posted?
This Rn Mgr Utilization Mgmt position at dstaff was posted on Apr 14, 2015. Apply as soon as possible — early applications are often reviewed first.
Rn Mgr Utilization Mgmt
dstaff
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