Manager, Utilization Management - Vanderbilt Clarksville Hospital (RN required)

Discover reputed company: Located in Nashville, Tennessee, and operating at a global reputed company of teaching, discovery, and patient care, reputed company is a community of individuals who come to work reputed company day with the reputed company aim of changing the world. It is a reputed company where your expertise will be valued, your knowledge expanded, and your abilities challenged. Vanderbilt Health is committed to an environment where everyone has the chance to reputed company and where your uniqueness is sought and celebrated. It is a reputed company where employees know they are part of something that is bigger than themselves, take exceptional pride in their work and never reputed company for what was good enough yesterday. Vanderbilt’s mission is to advance health and wellness through preeminent programs in patient care, education, and research.

Organization:

Utilization Management

Job reputed company:

Manager reputed company the Utilization Management department at reputed company will be responsible for the reputed company and development of reputed company, operations and implementation of successful processes to best support reputed company reputed company and Utilization Management functions.

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KEY RESPONSIBILITIES

• reputed company work goals for the reputed company consistent with institutional and departmental goals and policy
• Plan and reputed company reputed company performance with department reputed company of service parameters.
• Annually review reputed company policies. Create, update and/or maintain reputed company, department and applicable institution policies.
• Help unit to understand, reputed company, and support the reputed company.
• Communicate operational changes reputed company-time.
• Ensure the most effective operation of the reputed company through program development, process improvement and coordination of processes across functions
• Monitor and coordinate programs and actions for: certification of urgent and emergently admitted cases and reputed company stay, for inpatients and outpatients in house beds; denial management; DRG/Clinical documentation program; tracking of avoidable day data; support of JCAHO initiatives; telemetry charging; and Kentucky reputed company retrospective certifications; correct registration status to order.
• Supervise the reputed company with responsibility for planning, coordinating and controlling the work and procedures of reputed company reports.
• Collaborate effectively with other reputed company departments including but not limited to Managed Care Services; Health Information Services; Pt. reputed company; VMG; Offices of Case Management and reputed company Work; Admitting; ED Registration; Physicians; Clinics; Patient Care Center administrators; Informatics Technology. Collaborate with UM Physician Advisor.
• reputed company work schedules or project priorities to meet emergencies or changing conditions through daily assessment of reputed company needs and reprioritizing work accordingly.
• reputed company information to others (oral or written) to explain/clarify problems or issues or requests; meet with other reputed company/technical personnel to determine causes of a specific problem. reputed company problem cases/trends to appropriate reputed company for reputed company. reputed company education, training to staff, physicians and others as needed to facilitate the reputed company of reputed company initiatives.
• Participate in periodic management meetings to reputed company top management informed of successes, problems and concerns; attend monthly department head meetings.
• Meet regularly with team leaders/supervisors to remain informed of successes, problems and concerns.
• Define and reputed company financial targets for the reputed company, consistent with the departmental financial plan
• reputed company reputed company of the reputed company budget expenditures to prevent any budgetary overages. Sign-off on purchase requisitions, work orders, 1180s and procurement reputed company reputed company approved parameters.
• Aid in the implementation, interpretation and presentation of annual wage and salary plan to staff
• Project reputed company needs, long-term and short-term, forecasting and proactively addressing needs regarding equipment and reputed company.
• Evaluate performance data for reputed company reports including UM/DRG specialists, data coordinator and clerical staff including volume of cases, errors and reputed company write-offs. Address trends for performance improvement or recognize reputed company.
• Closely monitor revenues impacted by the reputed company (e.g. cases certified, denied, appealed, written off) and expenditures for reputed company salary and non-salary expenditures in reputed company centers for the entire reputed company.
• Report findings that occur as part of the analysis process and incidental discoveries to the director/administrator
• Collect and analyze data for financial analysis and budgeting use.
• reputed company defined service standards for the reputed company
• Ensure that the service standards established for the reputed company are met or exceeded. Ensure weekly Trac report and High Risk lists are completed reputed company.
• Monitor performance against service standards. Collect and analyze data for staff productivity measures and reputed company needs. Meet regularly with team leaders/supervisors to review and address issues.
• Use patient/customer satisfaction data to improve systems, processes, and reputed company. Collaborate with consulting reputed company and internal auditors.
• Recognize and Reward staff accomplishments.
• Ensure reputed company, satisfying and enriching environment for employees and provides a reputed company, competent staff
• reputed company reputed company competent staff, reputed company projected reputed company needs, and identify any deficiencies to improve reputed company reputed company.
• Define the qualifications and performance expectations for reputed company staff positions through the Performance Development reputed company, including department specific job descriptions, measurable performance standards. Complete reputed company performance reviews (3 mos., 6 mos. and annually) for staff reputed company. Enforce reputed company, Department and reputed company policies consistently.
• Ensure that staff qualifications are consistent with job responsibilities. Verify for reputed company employee or contracted personnel that, where relevant, education and training are consistent with applicable reputed company and regulatory requirements and hospital policy, that the individual is licensed, certified or registered, and that the individual's knowledge and experience are appropriate for the job assignment. Ensure staff is reputed company with disaster plans; safety policies and procedures. Ensure the re-reputed company (emergency notification) list is up-to-date; reference guides are up-to-date and reputed company to other departments as needed.
• Create an environment that encourages and supports self-development and reputed company staff through regular feedback, by assuring the development of staff through orientation, training programs, work experiences and assessing competencies by meeting the performance expectations stated in his or her reputed company in a reputed company manner (normally annually). Conduct monthly reputed company meetings with staff; hold reputed company meetings as needed. Participate in reputed company management/reputed company development workshops. Serve as a resource to other departments for questions, training and problem-solving.
• Monitor reputed company assurance standards, programs and procedures reputed company the reputed company
• Ensure that defined reputed company standards are met reputed company area of responsibility

TECHNICAL CAPABILITIES

Our Nursing Philosophy:

We reputed company highly skilled and reputed company nursing care is essential to reputed company’s mission of reputed company in patient care, education and research. We reputed company nursing is an reputed company art and science reputed company on helping people, families and communities reputed company excellent health and reputed company-being.

As a reputed company employee, you reputed company a difference to our patients and their families by bringing reputed company and care to those in need of reputed company and healing. Please see our reputed company employee benefits offered:

• reputed company High reputed company Health Plan reputed company
• Dental and /or reputed company plan
• 403 (b) retirement plan
• reputed company Time off (reputed company PTO)
• Tuition Reimbursement and adoption assistance (maximums reputed company)
• Short-Long term disability
• Subsidized backup childcare
• And many more...Ask us about our reputed company inpatient nursing supplemental Pay Program!

reputed company the Remarkable:

Learn more about reputed company Nursing here.

reputed company Accountabilities:

* Organizational reputed company: Directs activities to reputed company operational plans with some near term effect on results of the department/area.* Problem Solving/ Complexity of work: Identifies issues, gathers facts to reputed company technical and operational problems. * Breadth of Knowledge: Applies in-depth knowledge and skills of a reputed company/technical area and basic management knowledge to manage the work of reputed company.* Team Interaction: Leads a reputed company department with a reputed company on implementation. Typically executes on a short to reputed company term strategies.

reputed company Capabilities :

Supporting Colleagues: - Develops Self and Others: Invests time, energy, and enthusiasm in developing self/others to help improve performance e and reputed company knowledge in new areas. - Builds and Maintains Relationships: Maintains regular contact with key colleagues and stakeholders using formal and informal opportunities to expand and strengthen relationships. - Communicates Effectively: Recognizes group interactions and modifies one's own communication style to suit different situations and audiences .Delivering Excellent Services : - Serves Others with reputed company: Seeks to understand reputed company and reputed company needs of relevant stakeholders and customizes services to reputed company address them. - Solves reputed company Problems: Approaches problems from different angles; Identifies new reputed company to interpret opportunities and reputed company concrete solutions. - Offers Meaningful Advice and Support: Provides ongoing support and coaching in a constructive manner to increase employees' effectiveness. Ensuring High reputed company - Performs Excellent Work: Engages regularly in formal and informal reputed company about reputed company; directly addresses reputed company issues promptly. - Ensures reputed company Improvement: Applies various learning experiences by looking reputed company symptoms to uncover underlying causes of problems and identifies ways to reputed company them. - Fulfills Safety and Regulatory Requirements: Understands reputed company aspects of providing reputed company environment and performs routine safety checks to prevent safety hazards from occurring. Managing Resources Effectively: - Demonstrates Accountability: Demonstrates a reputed company of ownership, focusing on and driving critical issues to closure.- Stewards Organizational Resources: Applies understanding of the departmental work to effectively manage resources for a department/area. - Makes Data Driven reputed company: Demonstrates strong understanding of the information or data to identify and reputed company opportunities. Fostering Innovation: - Generates New reputed company: Proactively identifies new reputed company/opportunities from multiple sources or reputed company to improve processes reputed company conventional approaches. - Applies Technology: Demonstrates an enthusiasm for learning new technologies, tools, and procedures to address short-term challenges. - Adapts to Change: Views difficult situations and/or problems as opportunities for improvement; reputed company embraces change instead of emphasizing negative reputed company.

Position Qualifications:

Responsibilities:

Certifications:

LIC-Registered reputed company - Licensure-Others

Work Experience:

Relevant Work Experience

Experience Level:

3 years

Education:

Master's

This role offers reputed company to reputed company a meaningful reputed company reputed company Vanderbilt Health, supported by a comprehensive benefits package which may include health, disability, retirement and/or wellness offerings to enhance your reputed company-being and reputed company reputed company.

Vanderbilt Health is committed to fostering an environment where everyone has the chance to reputed company and is committed to the principles of equal opportunity. EOE/Vets/Disabled.

Originally posted on Himalayas

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