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The Utilization Management Nurse Manager excels in the application of clinical processes of assessment, planning, implementation, and evaluation of the Utilization Management Program, staff, and patients.
The UM Nurse Manager possess excellent communication, critical thinking and problem-solving skills in addition to an understanding of how the healthcare system works, including regulations, resource availability and acquisition processes and eligibility for services. Major duties include knowledge of admission and continued stay criteria for major disease categories for inpatient and observations admission. Close collaboration with providers in the Emergency Department and all admitting services at the Little Rock and North Little Rock campuses. Collaboration with other disciplines as indicated to ensure knowledge of criteria and consistent interpretation. Oversight of training of utilization management staff with annual validation of knowledge. Conducting interrater reliability assessments for consistent processes. Direct Supervision of RN Utilization Management Staff. Co-chair utilization management committee. Collect, organize and interpret data for presentation and reporting purposes.
Additional responsibilities include, but are not limited to, the following:
1. Collaboration with service-level leadership as well as unit-level staff to ensure integration and/or implementation of current internal/external standards into practice;
a) All aspects of clinical nursing care, patient care/education, patient and employee safety, continuum of care, information management, staff education/competency, leadership and performance improvement
b) Identification of alternative strategies/interventions for identified high risk patient/staff systems and processes
c) Monitoring activities for review and analysis of data for prioritization of performance improvement activities
d) Development of strategies to improve outcomes
e) Maintaining survey readiness
2. Participate, represent, collaborate, and lead committees, boards and teams, at service and medical center level.
3. Evaluates staff performance and facilitates staff development.
4. Working knowledge of personnel policies and procedures including EEO guidelines/policies and Labor Agreement
The successful candidate will utilize professional communication skills to accomplish the above and coordinate changes according to complex patient care needs.
Work Schedule: Day/Evening Weekdays with possible weekend tours based on the needs of the organization
Job family (Series)
This job originated on www.usajobs.gov. For the full announcement and to apply, visit www.usajobs.gov/GetJob/ViewDetails/532414700. Only resumes submitted according to the instructions on the job announcement listed at www.usajobs.gov will be considered.