Director Utilization Management

Department: Utilization Review

Work Hours: Primarily Monday through Friday, extended hours as needed to support organizational operations.

This position is responsible for implementing and leading the Heritage Valley Health System's Utilization Management, Case Management and Clinical Documentation programs in accordance with the mission, vision, values and strategic imperatives of the organization, federal and state law and regulations, and accreditation standards. Demonstrate proven results in improving clinical documentation, resource utilization management, case management to include transitions of care and other work processes related to the hospital stay and discharge planning.

Qualifications:

Required: Bachelor's Degree in nursing or other health related field; Current PA RN licensure; Demonstrated knowledge and experience applying Utilization Management, Case Management and Clinical Documentation principles in a hospital setting; Proficient in the use of Microsoft computer applications; Knowledge of federal and state regulations and accreditation agencies; Successful completion of Acts 73 and/or 169 clearances within 90 days of commencing employment, if applicable.

Preferred: Masters Degree in a health related field; Six Sigma training. Management experience in a health care setting.