Manager of Utilization Review RN Full Time Days BHS

Company: Baptist Health System
Location: San Antonio
Posted on: October 30, 2024

Job Description:

POSITION SUMMARY
The Manager of Utilization Review facilitates and supports an effective Utilization Review program within the Utilization Review department, which may be centralized within a specific market or group. The position has overall responsibility to ensure care is provided at the appropriate level of care based on medical necessity and assess the patient or transition needs to promote timely throughput, safe discharge, and prevent avoidable readmissions. The position manages medical necessity process for accurate and timely payment of services which may require negotiations with payer on a case-by-case basis. The UR Manager integrates national standards for case management scope of services. Assists the Group Director in support of the advancement of Centralized Utilization Review as a leader, mentor, and consultant. Assists the Group Director with executing on strategic initiatives and will provide subject matter expertise for Case Management - Utilization Review regulations and standards, including ensuring compliance with all state and federal regulations. Other related duties as assigned2403033369Employment practices will not be influenced or affected by an applicant's or employee's race, color, religion, sex (including pregnancy), national origin, age, disability, genetic information, sexual orientation, gender identity or expression, veteran status or any other legally protected status. Tenet will make reasonable accommodations for qualified individuals with disabilities unless doing so would result in an undue hardship.

Keywords: Baptist Health System, Pflugerville , Manager of Utilization Review RN Full Time Days BHS, Executive , San Antonio, Texas