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Manager, Utilization Review

Company: BayCare
Location: Saint Petersburg
Posted on: January 15, 2021

Job Description:

Description:The Manager Utilization Review plans, organizes and supervises the activities of the Utilization Team, prepares department for internal and external audits, conducts utilization management delegation audits and develops policies and procedures for adherence to governmental and accredited agency standards. The successful candidate will collaborate with other departments to develop and implement effective programs and processes in Utilization. Required Experience includes 3 years Case Management or 3 years Utilization Management and 3 years Acute Care Nursing and 2 years healthcare leadership role.Qualifications:Certifications and LicensuresRequiredRN (Registered Nurse)RequiredACM (Case Management)OrCCM (Case Manager)EducationRequiredBachelor'sNursingPreferredMaster'sNursingOrMaster'sBusinessExperienceRequired3 yearsCase ManagementOr3 yearsReference summary for detailsAnd3 yearsAcute CareAnd2 yearsLeadershipSpecific SkillsRequiredCustomer service skillsRequiredWritten and verbal communication skillsRequiredInterpersonal skillsRequiredDelegation skillsRequiredWork independentlyRequiredWork with a teamRequiredCritical thinking skillsRequiredOrganizational skillsRequiredAdministrative and clerical skillsRequiredComputer skills appropriate to positionRequiredKnowledge of regulatory standards appropriate to positionRequiredManagement skillsRequiredMedical terminology use and understanding

Keywords: BayCare, St. Petersburg , Manager, Utilization Review, Executive , Saint Petersburg, Florida

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