(USA-SD-SIOUX FALLS) Utilization Management Manager
The manager of the Utilization Management Department is responsible for the day to day oversight of department function both in terms of provision of service to members and providing direct supervision of all departmental staff except the Executive Assistant of the CMO. The manager is also responsible for assisting the UM Case Manager. This aspect of the job involves reviewing information submitted by internal or external referral sources regarding catastrophic cases which have the potential to develop into complex and or costly scenarios and assisting the finance department in understanding the financial implications of these conditions. Additional duties include management of pre and post transplant cases and management of medical denials, appeals, and grievances. The RN functions within the scope and standards of nursing practice as outlined in the South Dakota Nurse Practice Act and Administrative Rules. The Sanford Nursing Practice recognizes the Scope and Standards of Practice (2004) and the Code of Ethics for Nurses with Interpretive Statements (2001) as published by the American Nurses Association as the foundation of nursing care delivery. Experience with inpatient and ambulatory utilization is preferred but not required. The Manager must have the ability to generate, review, analyze and summarize reports. Effective oral and written communication skills are required. This position requires an understanding of medical terminology, typing and word processing skills, and an overall familiarity with computers. When students are providing patient care, treatment, and or services as part of their training, any all employees may be asked to supervise the students. Required Skills Graduation from a NLN or AACN accredited nursing program is strongly preferred. Graduate from an approved nursing program is acceptable. Bachelor s Degree in nursing preferred. Will consider applicant with associates degree and significant background in case management, transplant services and or other utilization review experience. Knowledge of the Epic Medical Record is preferred but not required. Previous managerial experience is required. Will be asked to complete a typing test with minimum score of no less than 40 words per minute.
(USA-SD-SIOUX FALLS) Utilization Management Manager
(USA-SD-SIOUX FALLS) Utilization Management Manager,(USA-SD-SIOUX FALLS) Utilization Management Manager,(USA-SD-SIOUX FALLS) Utilization Management Manager,(USA-SD-SIOUX FALLS) Utilization Management Manager,(USA-SD-SIOUX FALLS) Utilization Management Manager,(USA-SD-SIOUX FALLS) Utilization Management Manager,(USA-SD-SIOUX FALLS) Utilization Management Manager,(USA-SD-SIOUX FALLS) Utilization Management Manager,(USA-SD-SIOUX FALLS) Utilization Management Manager,(USA-SD-SIOUX FALLS) Utilization Management Manager from Jobs http://ift.tt/1fxF8bJ
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The manager of the Utilization Management Department is responsible for the day to day oversight of department function both in terms of provision of service to members and providing direct supervision of all departmental staff except the Executive Assistant of the CMO. The manager is also responsible for assisting the UM Case Manager. This aspect of the job involves reviewing information submitted by internal or external referral sources regarding catastrophic cases which have the potential to develop into complex and or costly scenarios and assisting the finance department in understanding the financial implications of these conditions. Additional duties include management of pre and post transplant cases and management of medical denials, appeals, and grievances. The RN functions within the scope and standards of nursing practice as outlined in the South Dakota Nurse Practice Act and Administrative Rules. The Sanford Nursing Practice recognizes the Scope and Standards of Practice (2004) and the Code of Ethics for Nurses with Interpretive Statements (2001) as published by the American Nurses Association as the foundation of nursing care delivery. Experience with inpatient and ambulatory utilization is preferred but not required. The Manager must have the ability to generate, review, analyze and summarize reports. Effective oral and written communication skills are required. This position requires an understanding of medical terminology, typing and word processing skills, and an overall familiarity with computers. When students are providing patient care, treatment, and or services as part of their training, any all employees may be asked to supervise the students. Required Skills Graduation from a NLN or AACN accredited nursing program is strongly preferred. Graduate from an approved nursing program is acceptable. Bachelor s Degree in nursing preferred. Will consider applicant with associates degree and significant background in case management, transplant services and or other utilization review experience. Knowledge of the Epic Medical Record is preferred but not required. Previous managerial experience is required. Will be asked to complete a typing test with minimum score of no less than 40 words per minute.
(USA-SD-SIOUX FALLS) Utilization Management Manager
(USA-SD-SIOUX FALLS) Utilization Management Manager,(USA-SD-SIOUX FALLS) Utilization Management Manager,(USA-SD-SIOUX FALLS) Utilization Management Manager,(USA-SD-SIOUX FALLS) Utilization Management Manager,(USA-SD-SIOUX FALLS) Utilization Management Manager,(USA-SD-SIOUX FALLS) Utilization Management Manager,(USA-SD-SIOUX FALLS) Utilization Management Manager,(USA-SD-SIOUX FALLS) Utilization Management Manager,(USA-SD-SIOUX FALLS) Utilization Management Manager,(USA-SD-SIOUX FALLS) Utilization Management Manager from Jobs http://ift.tt/1fxF8bJ
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