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Atrium Centers

Area Director of Utilization

Career Insights for Clinical Auditor / Utilization Reviewer

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What they do

A Clinical Auditor or Utilization Reviewer reviews the efficiency of healthcare delivery. Individuals tend to have had experience as a registered nurse or other healthcare delivery roles before transferring into this quality review role.

$91,785 / year median in Michigan

-10% projected decline

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Job Description

Area Director of Utilization Atrium Centers - 2.6 Grand Rapids, MI Job Details Full-time 1 day ago Benefits Paid holidays Health insurance Dental insurance Tuition reimbursement Paid time off Vision insurance 401(k) matching Employee discount Employee stock ownership plan Qualifications Long-term care regulations Medicare Utilization review Team leadership CMS CMS regulatory compliance Clinical data entry Medicare regulations Utilization management Leading team collaboration initiatives Quality data entry Full Job Description Atrium Centers…Be a light…to all residents, their families and team members "Our mission is to serve as a bright light in the lives of our residents and families by delivering compassionate, quality care in the communities they call home". Our foundation is based upon Compassion, Community and Clinical Excellence. Provides education, training, and support to regional and center staff on the resident assessment instrument (RAI) process in accordance with all laws, regulations and standards. Reviews and coordinates PDPM, Medicare management, managed care, and case mix data for assigned area to ensure appropriate utilization of available resources. Collaborates with corporate, regional, and center interdisciplinary teams.
DUTIES AND RESPONSIBISITLES
Monitors RAI processes (MDS accuracy, care plans, quality measures, care mapping, utilization review meeting, triple check, etc.) Oversees improvement plans for RAI processes as needed in assigned centers. Participate in the Quality Improvement and Corporate Compliance Programs as assigned. Assist in ensuring that quality improvement measures are continually maintained. Maintain an open rapport with all staff and departments to ensure that a team effort is achieved in providing superior services in each center. Understand and abide by the Corporate Standards of Conduct policies. Understand, comply with, and promote the Resident Bill of Rights. Maintain resident confidentiality and privacy. Promptly report all resident complaints, accidents, and incidents. Follow Atrium Centers policies and procedures written and utilized to comply with these standards Lead and/or participate in company initiative projects Participate in recruitment, selection, and training of center MDS staff.
QUALIFICATIONS
Registered Nursing Degree (or diploma) from an accredited college At least 5 years working with RAI process and PDPM at the regional or above level. Multi-facility experience required. Experience in Case Mix required if covering Ohio, Kentucky, or Wisconsin. Must have adequate computer skills, to accurately input data into the MDS and transmit that data; complete spread sheets; ability to navigate the CMS and other state resource sites; ability to communicate via email; and to pull reports from various computerized sources. Must possess effective leadership skills, demonstrate organizational skills, and must have knowledge of state and federal regulations for long-term care.
BENEFITS
100% Employee owned (ESOP) and offer 401(k) matching Medical/Dental/Vision/Life Insurances Milage Reimbursement Paid Time Off/Holiday Pay Tuition Reimbursement - Further your career with our support! Atrium Centers Discount Program - SAVE
ON TRAVEL, ELECTRONICS, HEALTH AND WELLNESS, AUTOMOTIVE AND MORE
We are Atrium Centers, and we invite you to see—first-hand—what we're all about. If you're committed to delivering compassionate, quality care in your local community, and believe in taking an all-hands, all-hearts approach to delivering top-notch care, apply with us today.