Nurse Manager Utilization Management Job Listing at MedStar Medical Group in Washington, DC (Job ID req33400)

Description

General Summary of Position

Responsible for evaluating the necessity, appropriateness and efficiency of the use of medical services procedures and facilities. Responsible for clinical review of all acute services for appropriateness based on medical criteria, the management of healthcare resources necessary and appropriate for achievement of desired outcomes, and the coordination of alternative levels of care for enrollees/members. Works collaboratively with interdisciplinary staff, both internal and external to the organization to facilitate the continuum of care, through education and advocacy to enhance health outcomes. We recruit, retain, and advance associates with diverse backgrounds, skills, and talents equitably at all levels.

*4 days per week on-site in DC*

Primary Duties and Responsibilities

Minimum Qualifications
Education

• Bachelor's degree from an accredited school of nursing or equivalent combination of education and experience required or

Experience

• 3-4 years Utilization management experience required and
• 5-7 years Diverse clinical experience required and
• 1-2 years 2 years Supervisory experience required

Licenses and Certifications

• RN - Registered Nurse - State Licensure and/or Compact State Licensure Valid RN License in the State of Maryland, Maryland CCM (Certified Case Manager) required or
• CCM - Certified Case Manager Valid RN License in the State of Maryland, Maryland CCM (Certified Case Manager) required
• achievement within 2 years of assuming the Manager position. required

Knowledge, Skills, and Abilities

• Excellent verbal and written communication skills.
• Ability to follow verbal and written instructions.
• Proficient computer with Microsoft Office applications especially Word, Excel and PowerPoint.
• Ability to enter and retrieve information using a PC.
• Working knowledge of various computer software applications.
• Knowledge of current trends in health care delivery and population management.
• Knowledge of NCQA, HEDIS, InterQual and local regulatory guidelines preferred.

This position has a hiring range of $100,588 - $180,419