General Summary of Position
Responsible for evaluating the necessity, appropriateness and efficiency of the use of medical services procedures and facilities.
Responsible for clinical review of all acute services for appropriateness based on medical criteria, the management of healthcare
resources necessary and appropriate for achievement of desired outcomes, and the coordination of alternative levels of care for
enrollees/members. Works collaboratively with interdisciplinary staff, both internal and external to the organization to facilitate the continuum of care, through education and advocacy to enhance health outcomes.Directs management of the Utilization Management Team to assure and maintain high quality and productivity standards; ensure results-oriented utilization management, timely customer service follow-up and strong communication skills.
*Please note that this position would require you to work 4 days on site in DC*
What We Offer
- Culture- Collaborative, inclusive, diverse, and supportive work environment.
- Career growth- Career mentoring to help you pursue your passions and gain skills to enhance your value.
- Wellbeing- Competitive salary and Total Rewards benefits to help keep you happy and healthy.
- Reputation- Regional & National recognition, advanced technology, and leading medical innovations.
Qualifications
- BSNfrom an accredited School of Nursing required.
- 3-4 years Utilization Management experience required, 5-7 years diverse clinical experience required, 1-2 years supervisory experience required.
- Active DC RN License and Basic Life Support for Healthcare providers required.
- CCM (Certified Case Manager) achievement within 2 years of assuming the Manager position required.
This position has a hiring range of $100,588 - $180,419