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1 Regional Director - Care Management/Clinical Documentation Job in King of Prussia, PA

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Regional Director - Care Management/Clinical Documentation
$130k-164k (estimate)
Full Time 1 Month Ago
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Universal Health Services, Inc. - Corporate Office is Hiring a Regional Director - Care Management/Clinical Documentation Near King of Prussia, PA

Responsibilities:
One of the nation’s largest and most respected providers of hospital and healthcare services, Universal Health Services, Inc. has built an impressive record of achievement and performance. Growing steadily since its inception into an esteemed Fortune 500 corporation, our annual revenues were $10.77 billion in 2018. In 2020, UHS was again recognized as one of the World’s Most Admired Companies by Fortune; in 2019, ranked #293 on the Fortune 500; and in 2017, listed #275 in Forbes inaugural ranking of America’s Top 500 Public Companies. Headquartered in King of Prussia, PA, UHS has more than 87,000 employees and through its subsidiaries operates 26 acute care hospitals, 327 behavioral health facilities, 40 outpatient facilities and ambulatory care access points, an insurance offering, a physician network and various related services located in 37 U.S. states, Washington, D.C., Puerto Rico and the United Kingdom.
The Regional Director of Care Management/Clinical Documentation Improvement is responsible for providing leadership in the development, implementation, and oversight of a care coordination model which will support a patient-centered care delivery model across the assigned region. This position is responsible for the development and implementation of standards, systems, policies, and procedures in alignment with organizational strategic initiatives and that is focused on quality and financial outcomes. Specifically, this position leads region wide efforts to optimize care coordination across the care continuum. The plan of care process will also ensure efficient resource utilization, quality outcomes, and maximize reimbursement. This position oversees the clinical documentation improvement program. This position closely collaborates with others in the corporate office and at the local level to optimize compliance with regulatory and payer requirements and to promote the delivery of high quality, efficient, cost-effective, and appropriate care.

Essential Job Duties:
  • Oversees and/or directs the development, implementation and standardization of region-wide clinical documentation improvement, care coordination, utilization management, and social work services policies, procedures and programs in conjunction with related goals and objectives. Ensures compliance with federal and state regulations, as well as established organizational policies and procedures
  • Establishes and oversees the development and implementation of programs, short and long-range goals and objectives and determines the optimal progression to obtain these goals. Reviews analyses and reports of various activities to determine department progress toward stated goals and objectives
  • Provides oversight for the medical necessity reviews, denials management, and utilization management supporting all areas of the organization within the assigned region. This includes strategy development which will improve reimbursements and reduce denials as related to federal, state and commercial programs in partnership with UHS Partners
  • Fosters integration and strong clinical partnerships with Hospitalists, physician advisors, local physician leadership and clinical integration activities in order to optimize care coordination across the care continuum, ensure efficient resource utilization, improve quality outcomes and enhance patient satisfaction
  • Maintains effective communication and a strong leadership presence with executive partners, senior leaders, internal and external customers to coordinate and adequately address patient care needs
  • Reviews, prepares, analyzes, and presents reports and recommendations to senior management regarding operations and/or other applicable areas of interest in order to provide concise and accurate information that aids in decision-making. Develops, reviews, and monitors clinical, service and financial outcomes using performance metrics
Qualifications:
Current RN license and Bachelor's Degree with a minimum of 8-10 years' experience required. Master's Degree preferred.
  • Extensive understanding of case management practices/clinical documentation and knowledge of reimbursement methodologies
  • Effective leadership, human relations and communications skills
  • Ability to identify and address needs in a team environment
  • Ability to effectively engage physicians, payers, management level staff, employees, and stakeholders in order to build partnerships, achieve strategic initiatives, and attain organizational goals
  • Ability to manage problems and situations where uncertainty is inherent constructing new and innovative solutions for complex and varying problems and situations while approaching issues/problems by considering the larger perspective or context
  • Analytical and conceptual system-thinking and the ability to manage multiple projects
  • Travel Requirement is approximately 25%
This opportunity provides a rewarding career, challenging and rewarding work environment as well as growth and development opportunities within UHS and its subsidiaries, including competitive compensation, excellent Medical, Dental, Vision and Prescription Drug Plan, and 401k with company match.
UHS is a registered trademark of UHS of Delaware, Inc., the management company for Universal Health Services, Inc. and a wholly-owned subsidiary of Universal Health Services, Inc. Universal Health Services, Inc. is a holding company and operates through its subsidiaries including its management company, UHS of Delaware, Inc. All healthcare and management operations are conducted by subsidiaries of Universal Health Services, Inc. To the extent any reference to "UHS or UHS facilities" on this website including any statements, articles or other publications contained herein relates to our healthcare or management operations it is referring to Universal Health Services' subsidiaries including UHS of Delaware. Further, the terms "we," "us," "our" or "the company" in such context similarly refer to the operations of Universal Health Services' subsidiaries including UHS of Delaware. Any employment referenced in this website is not with Universal Health Services, Inc. but solely with one of its subsidiaries including but not limited to UHS of Delaware, Inc.
UHS is not accepting unsolicited assistance from search firms for this employment opportunity. Please, no phone calls or emails. All resumes submitted by search firms to any employee at UHS via-email, the Internet or in any form and/or method without a valid written search agreement in place for this position will be deemed the sole property of UHS. No fee will be paid in the event the candidate is hired by UHS as a result of the referral or through other means.

Job Summary

JOB TYPE

Full Time

SALARY

$130k-164k (estimate)

POST DATE

04/15/2023

EXPIRATION DATE

05/17/2024

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