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Director, Utilization Review / Full-Time / (Posted 08/17/2021)
Plans, implements and evaluates the concurrent discharge planning and utilization management system with the intra-professional team and organizational leadership. Facilitates denial team and reviews data and processes to decrease denials. Stays up to date with all regulatory guidelines and community resources related to care transitions. Collaborates with outside agencies to review and improve transition of care. Provides up to date education for staff related to regulations and guidelines. Coordinates utilization resources to meet the needs of the organization.
Education and Credentials:
��� Graduate of accredited nursing program.
��� Current NC RN license or licensure from Nursing Compact State.
��� Certification in Case Management and/or Utilization Management.
Preferred: Master's degree in nursing or business
Five years utilization review experience. One year leadership experience. Given training and on-the-job experience, incumbent should be proficient in the basic aspects of the job within six months of employment date.
Hickory, North Carolina, United States