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Coordinator OF Case Management/Utilization Review

Expired Job

The Hutton Group, Inc Lubbock , TX 79401

Posted 1 week ago

COORDINATOROF CASE MANAGEMENT/UTILIZATION REVIEW
LOCATION: Lubbock, TX
Facility Type:
Hospital plus Ambulatory Surgery Center
Reports to: VP of Professional Services

GENERAL SUMMARY:
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.
ESSENTIAL FUNCTIONS:
  • 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
  • BCLS.
  • BSN preferred
  • Prior supervisory experience preferred
SALARY: $85 - $120K
CONTACT: Joan Hutton, President/CEO

The Hutton Group, Inc.
772-770-1787

hutton@huttongrouphc.com
www.huttongrouphc.com

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Coordinator OF Case Management/Utilization Review

Expired Job

The Hutton Group, Inc