DIR - UTILIZATION REVIEW / MGMT

UHS • Eagle Pass, TX

3d

About The Position

Responsible for the overall operation of the Case Management Department. Establishes policies, procedures, standards, and objectives for department operations. Evaluates performance and maintains quality improvement. Coordinates with other departments to provide a maximum level of services. Supervises all department staff. Must be able to demonstrate the knowledge and skill necessary to provide care, based on physical, psychosocial, educational and safety related criteria, appropriate to the age of the patients served in his / her assigned service area. The skills and knowledge needed to provide such care may be gained through education, training and / or experience..
Operational Oversight: Direct daily department activities, manage unit productivity, allocate resources, and ensure efficient use of technology.
Care Coordination: Oversee patient assessments, care planning, discharge planning, and transitions of care, integrating community services with acute care.
EEO Statement
All UHS subsidiaries are committed to providing an environment of mutual respect where equal employment opportunities are available to all applicants and teammates. UHS subsidiaries are equal opportunity employers and as such, openly support and fully commit to recruitment, selection, placement, promotion and compensation of individuals without regard to race, color, religion, age, sex (including pregnancy, gender identity, and sexual orientation), genetic information, national origin, disability status, protected veteran status or any other characteristic protected by federal, state or local laws.
We believe that diversity and inclusion among our teammates is critical to our success.
Notice
At UHS and all our subsidiaries, our Human Resources departments and recruiters are here to help prospective candidates by matching skillset and experience with the best possible career path at UHS and our subsidiaries. We take pride in creating a highly efficient and best in class candidate experience. During the recruitment process, no recruiter or employee will request financial or personal information (Social Security Number, credit card or bank information, etc.) from you via email. The recruiters will not email you from a public webmail client like Hotmail, Gmail, Yahoo Mail, etc. If you are suspicious of a job posting or job-related email mentioning UHS or its subsidiaries, let us know by contacting us at: https://uhs.alertline.com or 1-800-852-3449.

Requirements

• Bachelor’s degree in nursing.
• Must have Registered Nurse license in the State of Texas.
• Minimum of five years of clinical experience in a hospital setting.
• Expertise in case management principles, discharge planning, and regulatory requirements.
• Strong analytical, problem-solving, and change management abilities.
• Demonstrates knowledge and skills necessary to provide care appropriate to the age of the patient served.
• Ability to communicate effectively in writing and orally.
• Ability to work with multidisciplinary staff.
• Demonstrate a high level of medical, clinical, and nursing competence with the ability to make appropriate judgment.
• Working knowledge of current Medicaid / Medicare guidelines.
• Knowledge of TMF/ TDHS criteria for medical treatment.
• This position may require occasional travel.

Nice To Haves

• BLS preferred.
• Utilization Review / Discharge Planning background preferred.
• Bilingual preferred.

Responsibilities

• Responsible for the overall operation of the Case Management Department.
• Establishes policies, procedures, standards, and objectives for department operations.
• Evaluates performance and maintains quality improvement.
• Coordinates with other departments to provide a maximum level of services.
• Supervises all department staff.
• Must be able to demonstrate the knowledge and skill necessary to provide care, based on physical, psychosocial, educational and safety related criteria, appropriate to the age of the patients served in his / her assigned service area.
• Direct daily department activities, manage unit productivity, allocate resources, and ensure efficient use of technology.
• Oversee patient assessments, care planning, discharge planning, and transitions of care, integrating community services with acute care.

What This Job Offers

• Job Type: Full-time
• Career Level: Manager
• Number of Employees: 1,001-5,000 employees