Leads and directs the utilization review staff and function for a healthcare facility. Determines policies and procedures that incorporate best practices and ensure effective utilization reviews. Manages and monitors both concurrent reviews to ensure that the patient is getting the right care in a timely and cost-effective way and retrospective reviews after treatment has been completed. Provides analysis and reports of significant utilization trends, patterns, and impacts to resources. Consults with physicians and other professionals to develop improved utilization of effective and appropriat ...e services. Requires a master's degree. Typically reports to top management. Typically requires Registered Nurse(RN). Manages a departmental sub-function within a broader departmental function. Creates functional strategies and specific objectives for the sub-function and develops budgets/policies/procedures to support the functional infrastructure. Deep knowledge of the managed sub-function and solid knowledge of the overall departmental function. Typically requires 5+ years of managerial experience.More Show Less
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Welcome to CommonSpirit Health Mountain Region. Not sure what skills you will need for this opportunity Simply read the full description below to get a complete picture of candidate requirements. CommonSpirit Health Mountain Region is committed to building healthier communities, advocating for those who are poor and vulnerable, and innovating how and where healing can happen - both inside our hospitals and out in the community. With locations thr...
