Supervisor of Utilization Management

Location: United States

Notice

This position is no longer open.

315

Remote?: 1

Highlights (Bonus, shift, relocation, info for job):

Job Summary:

The Supervisor of Utilization Management understands the complexities of co-occurring conditions and social determinants of health, how they impact the overall health and wellbeing of our members.  The supervisor of utilization management is responsible for oversight of daily operations of the utilization management and transitional care management team including ensuring compliance with internal and NCQA timeliness and care plan/documentation standards, case file/performance reviews (e.g., case file audits, ride along, 1:1 coaching), participation in interdisciplinary care team meetings and rounds. The supervisor of utilization management leads team meetings and maintains team morale through virtual and in-person activities. 

Education & Experience:

  • Bachelor’s degree required.
  • Have and maintain a valid driver’s license in the state of practice.
  • Must be willing and able to travel up to 80% of the time to local area hospitals, skilled nursing facilities, acute rehabilitation facilities and office/center location to build relationships across interdisciplinary care team.
  • Licensed Registered Nursed in the state of practice with 5 or more years related to utilization management and case management experience.
  • 1+ year of supervisory experience preferred.
  • Multiple settings experience (acute inpatient, SNF and home health) preferred.
  • Familiar with care transitions, strategies for reducing readmissions and chronic condition management interventions a must.
  • Experienced in concurrent review for level of care determinations and taking action to transition to other care settings.
  • Experience working with high risk and medically complex patients with multiple comorbidities.

Why Work at AbsoluteCare?

At AbsoluteCare, we serve the most vulnerable individuals in America. These are our neighbors, people who are at higher risk for disease or who have multiple, complex, chronic illnesses. Often, they deal with an unequal healthcare system and wind up seeking basic care from emergency rooms. We take these patients out of those spaces and turn them into members: people who are entitled to some of the best, most focused care this country has to offer. 

We call this “care beyond medicine.” We have turned the doctor’s office into a comprehensive care center. Here, we surround our members with a core care team of doctors, nurses, social workers, and medical assistants who have the time and skills to get to know our members’ needs. We make the most important services available to our members under one roof. This includes a pharmacy, X-rays, a blood lab, nutrition services, urgent care, and much more.

We don’t stop at our four walls. We engage members in the communities where we all live to find the people who need us most. Through these community care teams, we remove the barriers to healthcare that so many people face daily. And it works

Our unique care is guided by our core values of accountability, caring, trust, and teamwork. We call it ACT2.

AbsoluteCare, Inc. provides equal employment opportunities (EEO) to all employees and applicants for employment without regard to sex, gender identity, sexual orientation, race, color, religion, national origin, age, disability, genetics, protected Veteran status, or any other characteristic protected by law or policy.

EEO Employer Verbiage: AbsoluteCare, Inc. provides equal employment opportunities (EEO) to all employees and applicants for employment without regard to sex, gender identity, sexual orientation, race, color, religion, national origin, age, disability, genetics, protected Veteran status, or any other characteristic protected by law or policy.

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