Supervisor of Utilization Management

<p>VillageCare is looking for a self-motivated and passionate RN with previous UM experience for our Supervisor of Utilization Management position.</p>



<p><strong>VillageCare is a community-based, not-for-profit organization serving people with chronic care needs, as well as seniors and individuals in need of continuing care and rehabilitation services.&nbsp;</strong></p> <p><strong>Our mission is to promote healing, better health and well-being to the fullest extent possible. &nbsp;<br /><br />Our care is offered through a comprehensive array of community and residential programs, as well as managed care. VillageCare has provided health care services to individuals residing within New York City for over 40 years.</strong></p>

keywords: um oversight,collboration,management,support,daily operations,experience,license & education,passion,knowledge



Overview: <p>This role helps to oversee daily functions of Utilization Management and gives administrative direction.</p> <p>&nbsp;</p>
Responsibilities: <p>In this role you will support quality and performance improvement initiatives while&nbsp;overseeing daily operations in Utilization management department. You will collaborate&nbsp; with physician peer reviewers and medical directors in determining coverage of requested services and counsel with physician advisors to coordinate case conference for complex case review. You will supervise daily Utilization Management functions and give administration direction. As the UM supervisor, you will provide oversight, review of all clinical interventions and coordination to decrease delays and denials.</p>
Requirements: We would like to speak to those who&nbsp; bring 2+ years of&nbsp;utilization review experience at a Managed Care Organization or Health Plan along with a&nbsp;BSN Degree. Must have current unrestricted NYS RN license, URAC/CCM preferred.&nbsp;1+ experience in supervisory role in healthcare and&nbsp;discharge planning strongly preferred.&nbsp;Knowledge of Medicaid and/or Medicare regulations required. Passionate attitude, communication skills and problem solving will be vital to this position.