DIRECTOR - UTILIZATION REVIEW / CASE MGMT

Responsibilities Cedar Hill Regional Medical Center - Opening in 2025! Apply promptly! A high volume of applicants is expected for the role as detailed below, do not wait to send your CV. When open in early 2025, Cedar Hill Regional Medical Center GW Health will be the first new full-service hospital in Washington, DC in more than 20 years! This teaching hospital will integrate clinical care with existing providers, The George Washington University Hospital, and the Urgent Care Center in Ward 8. This clinical integration will establish a robust system of care for all District residents, but more importantly, it will ensure residents of Wards 7 and 8 have access to high quality care in their community. This full-service hospital will include 136 beds (with the ability to expand to 184 beds), a verified trauma center, adult and pediatric emergency departments, maternal health and delivery, an ambulatory pavilion for physician offices, clinics, a community space, a 500-car garage and a helipad for emergency transports. We are seeking a Director of Utilization Review /Case Management: The Director will have 24-hour 7 day a week responsibility for the operational management and strategic planning of multiple services and/or a departments. Managerial Responsibilities In collaboration with the Chief Financial Officer, responsible for the development of both long- and short-range goals for the department and services that are consistent with goals and objectives of the hospital; ensures implementation of plans and the meeting of goals; and measures compliances in collaboration with hospital administration. Establishes course of action for self and others to accomplish a specific goal in concert with organizational objectives; plans appropriate follow-up activities unless otherwise communicated to supervisor with only rare exceptions. Monitors results. Educates and monitors staff regarding their own and the organizations responsibilities for regulatory compliance. Proactively identifies deficiencies and takes appropriate corrective action with only rare exception. Provides employees with clarity about expectations and clear feedback about performance, deals with performance problems in an appropriate and timely way with only rare exception. Responsible for implementation of, and employee compliance with, hospital policies and procedures and regulatory standards. Responsible for employee matters, which include staff selection, management, and development ensuring adequate numbers of qualified employees to provide safe, effective, and efficient services in accordance with established standards and productivity levels. Applies knowledge of growth and development over the life span and assesses and ensures competency and active license status (if appropriate) of the clinical staff. Utilization Management Plans, develops, coordinates and maintains manual and automated information, storage and retrieval systems relating to management of medical cases, case coordination, denial management, clinical pathways, utilization management, case mix and their integration into the health setting. Administrates and oversees the Case Management Program to procure and coordinate a seamless delivery of healthcare services, based on the patient's/client/families wishes and needs, that result in high-quality, cost-effective outcomes at any point through the continuum of care/service. Prepares reports utilization statically methodologies to display findings for analysis by the medical staff/and or professional staff. As a Cedar Hill Regional Medical Center employee, you will be part of an exceptional team with the following benefit offerings: Challenging and rewarding work environment. Competitive Compensation & Generous Paid Time Off. Excellent Medical, Dental, Vision and Prescription Drug Plans. 401(K) with company match and discounted stock plan. SoFi Student Loan Refinancing Program. Career development opportunities within UHS and its 300+ Subsidiaries! More information is available on our Benefits Guest Website: . QualificationsEducation/Qualification Education Requirements: BSN required. MS in nursing or Master's degree in related field preferred. Experience: Minimum of ten years of experience in utilization and case management in an acute care setting including 5 years at a supervisory level. Previous experience in case management, discharge planning or utilization management. Demonstration through prior employment history and course work. Consistent progressive leadership role responsibilities, fiduciary accountability and evidence of consistently exceeding departmental and/or business unit performance and financial objectives. Skills: Effective communication skills, both verbal and written. Effective interpersonal skills. Ability to maintain confidentiality. Ability to adapt to multiple and changing priorities. License / Certification: Current RN license in the District of Columbia required. Certification in specialty preferred. EEO Statement All UHS subsidiaries are committed to providing an environment of mutual respect where equal employment opportunities are available to all applicants and teammates. UHS subsidiaries are equal opportunity employers and as such, openly support and fully commit to recruitment, selection, placement, promotion and compensation of individuals without regard to race, color, religion, age, sex (including pregnancy, gender identity, and sexual orientation), genetic information, national origin, disability status, protected veteran status or any other characteristic protected by federal, state or local laws. We believe that diversity and inclusion among our teammates is critical to our success. Avoid and Report Recruitment Scams At UHS and all our subsidiaries, our Human Resources departments and recruiters are here to help prospective candidates by matching skill set and experience with the best possible career path at UHS and our subsidiaries. During the recruitment process, no recruiter or employee will request financial or personal information (e.g., Social Security Number, credit card or bank information, etc.) from you via email. Our recruiters will not email you from a public webmail client like Hotmail, Gmail, Yahoo Mail, etc. If you suspect a fraudulent job posting or job-related email mentioning UHS or its subsidiaries, we encourage you to report such concerns to appropriate law enforcement. We encourage you to refer to legitimate UHS and UHS subsidiary career websites to verify job opportunities and not rely on unsolicited calls from recruiters. Pay Transparency: To encourage pay transparency, promote pay equity, and proactively address regulations, UHS and all our subsidiaries will comply with all applicable state or local laws or regulations which require employers to provide wage or salary range information to job applicants and employees. Salary offers may be based on key factors such as education and related experience. #J-18808-Ljbffr

Created: 2025-01-01