Position Summary
Effectively leads and motivates the outpatient and preservice utilization management team to ensure the goals and standards of the department are being met. This position is responsible for oversight and management of the preservice utilization review team. Other functions include: day-to-day management, productivity monitoring, turnaround time monitoring, process improvement, letter review, compliance with regulations, provider appeals and auditing and overall outcomes of the department.
Basic Qualifications:
Education - Bachelor's Degree in in Nursing or related field (or equivalent education and experience)
Experience - 3 years of relevant experience in Leadership 5 years of relevant experience in Clinical experience in acute care or office setting
Licenses -
Registered Nurse (RN) Upon Hire
Preferred Qualifications:
Experience - 3 years of relevant experience in Managed care experience Knowledgeable of compliance and regulations as it relates to medical operations