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Coordinator OF Case Management/Utilization Review
The Hutton Group, Inc
Lubbock , TX 79401
Posted 1 week ago
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COORDINATOROF CASE MANAGEMENT/UTILIZATION REVIEW
LOCATION: Lubbock, TX
Hospital plus Ambulatory Surgery Center
Reports to: VP of Professional Services
The Director of Case Management/ Utilization Review is responsible for the development of staff and systems to effectively operate a comprehensive Case Management Program.
Provides leadership and supervision to the Case Management/Utilization Review team.
- Plans, directs, implements and monitors hospital-wide efforts to ensure appropriate level of care and psychosocial interventions.
- Servesas a liaison for the hospital with medical staff, hospital departments and services, regulator and extra review agencies, third party payers, financial services and community health and welfare services.
- Coordinates programs among departments and ensures services according to the appropriateness of care.
- Performs concurrent reviews for patients to ensure that extended stays are medically justified and documented in patients medical records.
- Refers to the Utilization Review Physician Advisor (s) all cases that do not meet established guidelines for admission or continued stay.
- Utilizes data to make informed decisions related to the delivery and outcomes of Case Management, department productivity and staffing.
- Assesses needs and plans, communicates and designs services that are appropriate to the hospital mission and patient/family needs.
- Complies monthly reports and statistics to the Utilization Review Committee.
MINIMUM EDUCATION AND EXPERIENCE REQUIRED:
- 3 5 years experience in a hospital setting as a case manager with utilization review experience
- Certification as a Case Manager preferred
LICENSURE AND CERTIFICATION:
- Licensed, or eligible for license as an RN in the state of Texas
- BSN preferred
- Prior supervisory experience preferred
SALARY: $85 - $120K
CONTACT: Joan Hutton, President/CEO
The Hutton Group, Inc.