AdventHealth Corporate
All the benefits and perks you need for you and your family:
- Benefits from Day One
- Career Development
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Our Promise To You
Joining AdventHealth is about being part of something bigger. It’s about belonging to a community that believes in the wholeness of each person, and serves to uplift others in body, mind and spirit. AdventHealth is a place where you can thrive professionally, and grow spiritually, by Extending the Healing Ministry of Christ. Where you will be valued for who you are and the unique experiences you bring to our purpose-minded team. All while understanding that together we are even better.
Shift: Full-time
Job Location: Remote
The Role You’ll Contribute
The Utilization Management RN Supervisor reports directly to the Divisional Utilization Management RN Manager and assists in monitoring and performing the daily operations and supervision of team members in the Utilization Management department. Utilization Management team members will have defined reporting accountabilities directly to Supervisors.
The Utilization Management RN Supervisor is responsible for the daily administrative tasks as assigned by the Utilization Management RN Manager. The Supervisor will serve as the primary point of contact for Utilization Management staff, physicians, and payors to provide mitigation for any barriers/concerns that may arise. The Utilization Management RN Supervisor will be responsible for supporting positive and safe patient outcomes, employee evaluations, and customer experience.
The Value That You Bring To The Team
- Supervises daily operations as directed by Divisional Utilization Management Manager, including:
I. Daily supervision of Utilization Management staff
II. Primary point of contact for Utilization Management barriers or concerns
III. May manage own assignment and department outcomes, as directed
- Assists Utilization Management Manager to successfully implement practice changes
- Serves as an initial point of contact for all identified stakeholders [i.e. Utilization Management staff, Physician Advisor(s), payors, leadership]
- Serves as a Utilization Management content expert regarding medical necessity criteria, patient status, level of care, regulatory compliance, etc.
- Performs chart reviews to validate that policy, procedure and standards are met
- Escalates operational and/or financial concerns to the Physician Advisor(s), as appropriate
- Reports pertinent quality/risk issues to appropriate individuals, departments and/or committees in a timely manner
- Discusses staff, physician, and other department complaints with Utilization Management Manager and follows up with a written report submitted within 24 hours, as needed
- Maintains caseload and performs daily pre-admission, admission, and concurrent utilization reviews by leveraging Cortex logic to determine appropriate levels of care and support Care Management team for readiness for discharge, as directed
- Demonstrates a positive problem-solving attitude to staff, physicians and peers
- Serves as a supportive change agent for Utilization Management model processes
- Acts as a role model for Utilization Management department staff
- Encourages team member engagement
- Maintains open communication with staff
- Assists with staff performance reviews/evaluations
- Provides support and oversight with progressive corrective action plans
- Balances schedules to meet department needs prior to posting
- Communicates changes to expected schedule minimizes unscheduled absences
- Plans job responsibilities for maximum utilization of staff
- Resolves daily staffing issues
The Expertise And Experiences You’ll Need To Succeed
- Associate Degree in Nursing
- Minimum three years acute care clinical nursing experience required.
- 2-3 years of experience in direct Utilization Management with increasing level of responsibility
- Excellent interpersonal communication and negotiation skill.
- Strong analytical, data management, and computer skills.
- Strong organizational and time management skills, as evidenced by capacity to prioritize multiple tasks and role components.
- RN License
Preferred Qualifications
- Bachelor of Science in Nursing
- Clinical experience in acute care facility
- Experience mentoring others
- ACM, CCM
This facility is an equal opportunity employer and complies with federal, state and local anti-discrimination laws, regulations and ordinances. The salary range reflects the anticipated base pay range for this position. Individual compensation is determined based on skills, experience and other relevant factors within this pay range. The minimums and maximums for each position may vary based on geographical