Manager, Utilization Review Position Available In Fulton, Georgia

Manager, Utilization Review Emory Healthcare – 3.8 Atlanta, GA Job Details Full-time $56.28 – $65.25 an hour 1 day ago Benefits Wellness program Health insurance Benefits from day one Loan assistance Qualifications Nursing 3 years Master’s degree Bachelor’s degree Case management Master of Nursing Senior level

Leadership Full Job Description Overview:

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We provide:

Comprehensive health benefits that start day 1 Student Loan Repayment Assistance & Reimbursement Programs Family-focused benefits Wellness incentives Ongoing mentorship, development, and leadership programs And more

Work Location:

Atlanta, GA Description:

The Manager, Utilization Review (UR) is responsible for direct oversight of the daily operations of the UR Department. The UR Manager will ensure departmental day to day operations are successful by creating schedules, arranging coverage and dividing work as necessary in order to ensure work is completed in a timely manner which will ensure compliance with the Utilization Review Plan and regulatory/compliance guidelines. The UR Manager is responsible for maintaining, managing, and processes and procedures as it relates to day to day workflow. The UR Manager will be responsible for collaborating with Case Management/Utilization Review Leadership in order to successfully implement new policies and procedures. The UR Manager is responsible for identifying opportunities for improvement in workflows/processes as well as working through resolution when such things are identified. The UR Manager will ensure the department is compliant by ensuring the team adheres to established policies and procedures. The UR Manager will ensure Case Management systems and tools are being utilized as designed including staying up to date with system updates and upgrades. The UR Manager will consistently monitor quality and productivity standards in order to manage individual performance as well as the teams overall performance. The UR Manager will understand key performance indicators for the Utilization Review Department and be actively working with their teams to achieve them. The UR Manager will be transparent in sharing performance-based metrics with their teams and have accountability to those metrics. The UR Manager regularly meets with, seeks input and recommendations from, and communicates operational changes to staff. The UR Manager will be responsible for coaching, developing, training, and the performance management process for employees. The UR Manager will ensure department, division, and system strategic goals are connected to the daily work of the department. The UR Manager will work with Case Management Leadership and Physician Advisors across the system. The UR Manager will collaborate with the interdisciplinary teams as well as the revenue cycle teams. The UR Manager must be able to successfully complete all roles within the department at any given time as well as be able to problem solve complex inquires and provide direction and oversight to the team.

MINIMUM QUALIFICATIONS

Must have a valid, active unencumbered Nursing license or temporary permit approved by the Georgia Licensing Board. Bachelor’s degree in nursing required but Master’s degree in nursing or related field preferred. 3 years experience in Case Management (CM) required. 3 years healthcare experience required. Case Management certification preferred. Leadership experience preferred. Proven ability to coach, mentor, and lead. Demonstrates leadership abilities.

Additional Details:

Emory is an equal opportunity employer, and qualified applicants will receive consideration for employment without regard to race, color, religion, sex, national origin, disability, protected veteran status or other characteristics protected by state or federal law. Emory Healthcare is committed to providing reasonable accommodations to qualified individuals with disabilities upon request. Please contact Emory Healthcare’s Human Resources at . Please note that one week’s advance notice is preferred.