Job Openings in Sacramento County and Beyond
Utilization Review Team Manager - Direct Hire
Shasta County, CA | Direct Hire Position
Responsibilities: Tracks, monitors, manages and distributes work and assignments to appropriate staff in accordance with job descriptions, practice level, and business needs. Provides administrative, technical, and clinical management of assigned staff in accordance with industry best practices which includes training oversight, hiring, performance evaluation, performance improvement, education, staff development, work allocation and problem resolution. Performs auditing and review for Health Services leadership including concurrent review, retrospective review, and individual case audits. Provides summaryof findings to Health Services leadership as requested. Ensures compliance with all departmental and organizationalpolicy and procedures. Participates in all audits or surveys as requested by preparing documentation or reports as needed. Participates in identifying and developing departmental goals to further organizational goals and mission.
Requirements: 5 years acute care experience, 2 years managed care experience. Minimum one year priorexperience in a leadership role. Bachelors of Science in Nursing preferred. Working knowledge of ICD-10-CM, CPT, length of stay guidelines, and clinical indications for inpatient stays. Current California Registered Nurse License. Strong leadership, program evaluation and management skills. Thorough knowledge of Care Coordination, Discharge Planning, Case Management and Utilization Review within a managed care environment. Ability to work within a fast-paced environment while managing multiple priorities and deadlines. Highly organized with excellent problem solving, written and verbal communication skills. Demonstrated experience and ability to build effective working relationships. Ability to supervise, train, motivate, provide guidance to staff.