Supervisor Utilization Review, Remote, Full Time, First (Finance)
Supervisor, Utilization Review
UC Health is hiring a full-time Supervisor, Utilization Review for the first shift.
This person will require high-quality professionalism within our organization.
About UC Health
UC Health is an integrated academic health system serving Greater Cincinnati and Northern Kentucky. In partnership with the University of Cincinnati, UC Health combines clinical expertise and compassion with research and teaching-a combination that provides patients with options for even the most complex situations. Members of UC Health include: UC Medical Center, West Chester Hospital, Daniel Drake Center for Post-Acute Care, Bridgeway Pointe Assisted Living, University of Cincinnati Physicians and UC Health Ambulatory Services (with more than 900 board-certified clinicians and surgeons), Lindner Center of HOPE and several specialized institutes including: UC Gardner Neuroscience Institute and the University of Cincinnati Cancer Center. Many UC Health locations have received national recognition for outstanding quality and patient satisfaction. Learn more at uchealth.com.
- Bachelor's Degree is Nursing is required.
- Current Ohio RN License.
- Preferred - Certification in Utilization Review or Case Management
- 3 Years equivalent experience - Minimum Required
- This position requires five (3-5) years combination of clinical nursing and/or utilization review/case management, and leadership experience in an acute care setting is expected. Third party administration experience a plus, but not required.
- Knowledge of and ability to apply clinical decision support/medical necessity criteria.
- Current knowledge of rules, regulations, policies and procedures related to JCAHO, CMS and other regulatory, licensing, and accrediting agencies required.
Hours: Full-time, 40 hours/week
Shift: First Shift
While the position will work in a remote office environment, travel to the various hospitals and work locations will be necessary. Work hours will vary from time to time depending upon the needs of the business. Regular and predictable on-site attendance is required for this position.
Join our team as an Utilization Review Supervisor, for UC Health and work alongside the best and brightest leaders and administrators collaborating toward our common purpose: to advance healing and reduce suffering.
Join our team to BE UC Health. Be Extraordinary. Be Supported. Be Hope. Apply Today!
About UC Health
UC Health is an integrated academic health system serving Greater Cincinnati and Northern Kentucky. In partnership with the University of Cincinnati, UC Health combines clinical expertise and compassion with research and teaching-a combination that provides patients with options for even the most complex situations. Members of UC Health include: UC Medical Center, West Chester Hospital, Daniel Drake Center for Post-Acute Care, Bridgeway Pointe Assisted Living, University of Cincinnati Physicians and UC Health Ambulatory Services (with more than 900 board-certified clinicians and surgeons), Lindner Center of HOPE and several specialized institutes including: UC Gardner Neuroscience Institute and the University of Cincinnati Cancer Center. Many UC Health locations have received national recognition for outstanding quality and patient satisfaction. Learn more at uchealth.com.Job Responsibilities
The UR Supervisor, functioning as a professional registered nurse, is responsible and accountable for directing and insuring quality nursing care, effective utilization of resources, and maintaining sound organizational relationships as delegated by the UR Director. The Supervisor is competent in all areas of the Utilization Review Department. The Supervisor collaborates with the UR Director to plan, organize and evaluate department processes to assure cost effective delivery of care.
- Demonstrates competency to function in utilization nurse role.
- Review observation cases and provide feedback to staff.
- Will be required to have full utilization review nurse assignment, as needed determined by staffing need.
- Assists with the identification and implementation of annual performance improvement projects.
- Assures staff compliance with hospital policies, departmental goals, performance improvement initiatives, and regulatory agency requirements.
- Assists Director with budget development and review.
- Maintain current knowledge and skills related to Utilization Review
The UR Supervisor, functioning as a professional registered nurse, is responsible and accountable for directing and insuring quality nursing care, effective utilization of resources, and maintaining sound organizational relationships as delegated by the UR Director. The Supervisor is competent in all areas of the Utilization Review Department. The Supervisor collaborates with the UR Director to plan, organize and evaluate department processes to assure cost effective delivery of care.
- Demonstrates competency to function in utilization nurse role.
- Review observation cases and provide feedback to staff.
- Will be required to have full utilization review nurse assignment, as needed determined by staffing need.
- Assists with the identification and implementation of annual performance improvement projects.
- Assures staff compliance with hospital policies, departmental goals, performance improvement initiatives, and regulatory agency requirements.
- Assists Director with budget development and review.
- Maintain current knowledge and skills related to Utilization Review
