Under the direction of the AVP of Clinical Review and Discharge Planning, the Director of Clinical Review maintains daily operations of the hospital Clinical Review Department. Excellent communication and interpersonal skills. Team building skills with the ability to function independently and interdependently as a member of the Care Management Leadership Team. Demonstrates the ability to be flexible in work schedules and coverage; this includes the ability to manage some staff remotely. Strong organizational, innovation, and problem-solving skills. Strong decision-making skills. Ability to establish strong team building with the both internal and external customers.
Directs daily UM operations for the department including staffing, schedules, recruitment, onboarding, and performance management. Responsible for maintaining budget and contributing to future budget development.
Monitors departmental performance indicators, goals and objectives that are consistent with organizational strategic goals, mission, and vision.
Monitors departmental objectives consistent with revenue cycle plan for DNFB, denials, and appeals. Monitors reports and workqueues. In collaboration with the AVP, Medical Director of UM annually evaluates the UM plan to meet compliance standards.
Maintain the quality of the review process among all personnel including development and implementation of staff audits that give meaningful and measureable data and an understanding of strengths and areas for improvement. Responsible for the development and implementation of process improvements. Reviews observation/SDS cases daily and initiates communication and referral activity to ensure correct status designation. Active participant in the Utilization Management Committee and subject matter expert who acts as a resource to the team. Recruits, evaluates, mentors, and conduct appropriate disciplinary actions for UM staff. Collaborates with Physician advisors, and AVP to assure workflows and cases are being addressed according to plan. The above are guidelines for the position but are not necessarily a delineation of all the actions/duties necessary to the job.
Project Manager - Federal - ( 240000J0 ) Description Stantec Buildings is on a mission to become... ...for successful delivery of the project as a part of the overall program. Ensure effective and timely communication between the various project teams...
...Our doctors also have access to:Full Heska in-house labIn-house coag and blood gasDigital radiology with remote radiologist readsSamsung V7 ultrasoundHallmarq Gen 3 MRI (1.5T)Aquillion CT (128 slice)Siemens C-armFull surgical suitesOxygen cages among other...
...Job Description Job Description Heavy Haul Truck Driver Excellent Pay, Benefits & More! Friessen Construction is hiring an experienced person to move construction equipment from job site to job site as needed. When not transporting equipment, you will be pulling...
...HourlyLocation : El Paso, TXJob Type: Part-timeJob Number: PT Pool 2024-2025Division: VP... ...and the University of Texas at El Paso to work together to strengthen existing ties... ...to engage in collaborative mentoring of students and faculty across the institutions in humanities...
Security OfficerWe're looking for a qualified Security Officers like you to join our Texas Health family.Position HighlightsWork... ...required upon hire.CSO - Commissioned Security Officer Texas Private Security Level 2 (not required if have Level 3) required within...