2 System Utilization Review Nurse Manager Jobs in Montgomery, AL
Baptist Health is Hiring a System Utilization Review Nurse Manager Near Montgomery, AL
The RN - Utilization Review Nurse Manager shall manage the daily Utilization Review and Appeals Management processes for the facilities within Baptist Health. This individual shall administer policies and operational procedures necessary to coordinate the resources needed for utilization review and appeal management. Additionally, the Manager shall be responsible for allocation and management of human resources in assigned departments. The Manager is responsible to manage a team of Utilization Review and Appeal Management Specialists, to develop and implement utilization review protocols, and collaborate with various departments to optimize resource utilization. The Manager will coordinate care of patients through collaboration with physicians, nursing staff and other health professionals. The position facilitates efficient utilization of resources; optimize clinical and financial outcomes; while promoting physician, patient and employee satisfaction. This position may have additional duties assigned that are within scope of the role. Description
- Degree in Nursing, Master's degree preferred.
- Minimum 3-5 years' hospital-based experience in concurrent utilization review required.
- Minimum 3-5 years of hospital-based appeals management experience required.
- Minimum 3-5 years' experience in third party payor requirements required.
- Minimum 3-5 years of similar leadership experience required.
- Knowledge of Joint Commission and CMS Conditions of Participation preferred.
- Active RN licensure required.
- Change Healthcare InterQual Certified Expert Resource Certification required or will acquire within year of hire.
- Certified Case Manager (CCM) certification preferred.
- Excellent interpersonal skills and the ability to work under stressful conditions
- Knowledge of generally accepted hospital policies and procedures
- Organizational skills
- Good written and oral communication skills
- Ability to foster a cooperative work environment
- Effective supervisory and leadership skills
- Strong customer service skills
- Ability to resolve customer complaints and concerns
- Employee development and performance management skill
Job Summary
Full Time
$75k-96k (estimate)
05/02/2024
05/15/2024
baptist-health.com
LITTLE ROCK, AR
3,000 - 7,500
1921
RUSS HARRINGTON
$1B - $3B
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About Baptist Health
Baptist Health of Arkansas: Dedicated to Wellness, Driven by Purpose On February 16, 1921, the Pulaski County Circuit Court ordered the incorporation of Baptist State Hospital, and the organization that would eventually grow into the Baptist Health system was born. Though the original hospital opened its doors in Little Rock with less than a hundred beds in a small building, the purpose was significant create a healthier community through Christian compassion and innovative services. While much has changed over the past century, our goal has remained the same and has served as the driving for...ce behind all weve accomplished. Today, Baptist Health is Arkansas most comprehensive healthcare organization with more than 200 points of access that include 11 hospitals, urgent care centers, a senior living community, and over 100 primary and specialty care clinics in Arkansas and eastern Oklahoma. The system additionally offers a college with studies in nursing and allied health, a graduate residency program, and access to virtual care through a mobile app. Baptist Health, as the largest not-for-profit health care organization based in Arkansas, provides care to patients wherever they are through the support of approximately 11,000 employees, groundbreaking treatments, renowned physicians, and community outreach programs.
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