Healthcare
Hire the right healthcare staff with speed and precision locally or nationwide.
Back to jobs
Manager of UM
- Posted: September 16, 2024
- Salary:US$97843.00 - US$163000 per year + full benefits package
- Location:Washington
- Job type: Permanent
- Discipline:Care Management
- Reference:234087_1726507464
- Work Location:On-site
Job description
In this role you will manage activities and staff of the Utilization Review and Clinical Documentation Improvement department.
Some responsibilites are...
- Monitor the performance of the UR team
- Overseeing 8 urses and 5-6 prn nurses
- Advocate for the UM team against payers as well as with providers
- Needs someone that can be very hands on when staffing is short
- Participate in budget development and recommend budgets
- Supervise/Evaluate the work of these teams in accordance with departmental policies
- Collection and analysis of data to report on the effectiveness of process improvement to the organization and department
- Work directly with payors, Managed Care to enhance communication and improve authorization processes
- Track clinical, operational, quality and financial data related to CRM and CDI
- Participate in the planning, development and implementation of the clinical documentation
- Analyze and report data related to case management activities, payer activities, resource utilization, and clinical denials
- Educate members on documentation guidelines, clinical care, levels of care and anything finanical
Monday-Friday
8:00-5:00pm
In person
Qualifications:
- 7+ years of healthcare experience
- 2+ years experience in a healthcare manager role
- 3+ years UR/UM experience
- DC RN license
- Experience with Milliman and/or Interqual