Utilization Management RN Supervisor Full Time Days

Company: AdventHealth Daytona Beach
Location: Daytona Beach
Posted on: November 15, 2021

Job Description:

DescriptionUtilization Management RN Supervisor Full Time Days AdventHealth Daytona Beach Location Address:-- -301 Memorial Medical Parkway Daytona Beach, FL 32117 100%-- -REMOTE POSITION Top Reasons to Work at AdventHealth-- - Great benefits such as: Educational Reimbursement Career growth and advancement potential High quality of life with low cost of living-- - Immediate Benefits Work Hours/Shift: -- -Full-Time / Days You Will Be Responsible For: Supervises daily operations as directed by Divisional Utilization Management Manager, including: o-- --- --- - Daily supervision of Utilization Management staff o-- --- --- - Primary point of contact for Utilization Management barriers or concerns o-- --- --- - May manage own assignment and department outcomes, as directed Assists Utilization Management Manager to successfully implement practice changes Serves as an initial point of contact for all identified stakeholders [i.e. Utilization Management staff, Physician Advisor(s), payors, leadership] Serves as a Utilization Management content expert regarding medical necessity criteria, patient status, level of care, regulatory compliance, etc. Performs chart reviews to validate that policy, procedure and standards are met Escalates operational and/or financial concerns to the Physician Advisor(s), as appropriate Reports pertinent quality/risk issues to appropriate individuals, departments and/or committees in a timely manner Discusses staff, physician, and other department complaints with Utilization Management Manager and follows up with a written report submitted within 24 hours, as needed Maintains caseload and performs daily pre-admission, admission, and concurrent utilization reviews by leveraging Cortex logic to determine appropriate levels of care and support Care Management team for readiness for discharge, as directed Demonstrates a positive problem-solving attitude to staff, physicians and peers Serves as a supportive change agent for Utilization Management model processes Acts as a role model for Utilization Management department staff Encourages team member engagement Maintains open communication with staff Assists with staff performance reviews/evaluations Provides support and oversight with progressive corrective action plans Balances schedules to meet department needs prior to posting Communicates changes to expected schedule-- --- - minimizes unscheduled absences Plans job responsibilities for maximum utilization of staff Resolves daily staffing issues Knowledge of Care Management processes/workflows Knowledge of Utilization Management processes, medical necessity criteria, and compliance guidelines Ability to lead others effectively Ability to manage multiple tasks and prioritize level of importance Critical thinking skills Customer service skills Ability to implement process improvement processes Experience with Microsoft applications and development of reports Strong professional verbal and electronic communication Ability to negotiate optimal resolution of issues Ability to engage in complex clinical decision -- -making Conflict resolution skills Ability to analyze, evaluate, and monitor data Ability to foster positive Interdisciplinary Team relations and encourage employee engagement Ability to work independently and/or as part of a team QualificationsWhat You Will Need: RN License (required) Associate Degree in Nursing Minimum three years acute care clinical nursing experience required. 2-3 years of experience in direct Utilization Management with increasing level of responsibility Excellent interpersonal communication and negotiation skill. Strong analytical, data management, and computer skills. Strong organizational and time management skills, as evidenced by capacity to prioritize multiple tasks and role components Bachelor of Science in Nursing Clinical experience in acute care facility Experience mentoring others ACM, CCM (preferred) Job Summary: The Utilization Management RN Supervisor reports directly to the Divisional Utilization Management RN Manager and assists in monitoring and performing the daily operations and supervision of team members in the Utilization Management department. Utilization Management team members will have defined reporting accountabilities directly to Supervisors. The Utilization Management RN Supervisor is responsible for the daily administrative tasks as assigned by the Utilization Management RN Manager. The Supervisor will serve as the primary point of contact for Utilization Management staff, physicians, and payors to provide mitigation for any barriers/concerns that may arise. The Utilization Management RN Supervisor will be responsible for supporting positive and safe patient outcomes, employee evaluations, and customer experience. This facility is an equal opportunity employer and complies with federal, state and local anti-discrimination laws, regulations and ordinances.

Keywords: AdventHealth Daytona Beach, Daytona Beach , Utilization Management RN Supervisor Full Time Days, Healthcare , Daytona Beach, Florida