Director Utilization Management-Clinical Review

Texas Health Resources • VA

105d

About The Position

The Director will be the department leader for system services for wholly owned and Partner hospitals for utilization management. This position is hybrid remote/onsite, with the vast majority of time being remote, but there will be ad hoc and required meetings onsite throughout the year.

Requirements

• Bachelor's Degree in Nursing required.
• 3 years clinical experience in an acute hospital setting required.
• 3 years Utilization Management required.
• 3 years previous leadership experience required.
• RN - Registered Nurse Current license to practice professional nursing in the state of Texas required upon hire.

Nice To Haves

• Master's Degree preferred.
• ACM - Accredited Case Manager or CCM, CPHM or Milliman certification preferred upon hire.

Responsibilities

• Plans, organizes and delegates activities as required for safe, efficient and effective operation of the unit/area including active participation with other hospital and leadership staff.
• Demonstrates technical, practical and academic knowledge to manage the department.
• Identifies and utilizes processes and resources that support optimal delivery of data and information to staff.
• Meets productivity standards and staffing needs.
• Fosters a work environment favorable to retaining staff.
• Responsible for personnel functions including staffing, performance reviews and corrective action.
• Promotes professional growth and development of employees.
• Maintains a predictable schedule, including time on and off shifts such as weekends and holidays.
• Maintains collegial relationships with staff, physicians, other departments and Administration.
• Prepares operating and capital budgets for areas of responsibility.
• Manages approved operating and capital budgets effectively and adjusts strategies as needed to meet budget expectations.
• Identifies and evaluates patient care requirements and outcomes based upon patient acuity, system and budgetary guidelines.
• Develops, implements, monitors and assesses processes that impact patient outcomes.

Benefits

• Family-friendly hours.
• Top-notch benefits.
• Career growth and professional development opportunities.

What This Job Offers

• Job Type: Full-time
• Career Level: Director
• Education Level: Bachelor's degree
• Number of Employees: 5,001-10,000 employees