Colorado Veterans Jobs

Colorado Veterans Jobs

Job Information

SCL Health Manager Utilization Review in Grand Junction, Colorado

You.You bring your body, mind, heart and spirit to your work as a Manager ofUtilization Review.You know how to move fast. You know how to stay organized. You know how tohave fun.You're equally comfortable with day-to-day operational leadership, programdevelopment, human resources management, fiscal management, patientsafety and satisfaction, and regulatory compliance.You're great at what you do, but you want to be part of something evengreater. Because you believe that while individuals can be strong, the rightteam is invincible.Us.A faith-based, nonprofit healthcare organizationthat focuses on person-centered care. Our 346-bed regional medical center isin Grand Junction, one of the most beautiful places on earth. Our mission isto bring health and hope to the poor, the vulnerable, our communities andeach other.are one of the ways we encourage health for you and your family. Our generouspackage includes medical, dental and vision coverage. But health is morethan a well-working body: it encompasses body, mind and social well-being.To that end, we've launched a Healthy Living program to address yourholistic health. Healthy Living includes financial incentives, digitaltools, tobacco cessation, classes, counseling and paid time off. We alsooffer financial wellness tools and retirement planning.We.Together we'll align mission and careers, values and workplace. We'llencourage joy and take pride in our integrity.We'll laugh at each other's jokes (even the bad ones). We'll helloand high five. We'll celebrate milestones and acknowledge the value ofspirituality in healing.We're proud of what we know, which includes how much there is to learn.Your day.As a Manager of Utilization Review, you need to know how to:Participates and manages improvement initiatives. Coordinates orientation andtraining of new associates. Ensures staff competency through proper trainingtechniques and conducts quality audits.Participates in problem solving to address issues relating to patientsafety, care and service. Supports and promotes effective working relationsand works effectively as part of a department/unit team andinterdepartmentally to facilitate that department's ability to meet itsgoals and objective. Collaborates with department leadership team tocoordinate care with other departments and promote the highest level ofpatient care and satisfaction.May participate in human resource functions. May participate in the interviewprocess and provides feedback to leadership team on candidates. Provideseducation/training and performance feedback for associates in thedepartment. Participates in policy and procedure development. Presents anddocuments staff meetings as required.Participates in management of quality and performance improvement initiatives.Ensures compliance with applicable regulatory guidelines and establisheddepartmental policies and procedures, objectives, quality assuranceprogram, safety, environmental and infection control standards.Uses nationally recognized review criteria to ensure that patient status is atthe appropriate level of care. Collaborates with physicians and care managersto support an appropriate and timely patient discharge.Understands CMS medical necessity requirements and the coordination of carerequired under Federal and State regulations. 8. Performs initial review andauthorizations for admission. Performs concurrent reviews to ensure thatextended stays are medically necessary and justification is documented in themedical record. Performs ongoing review of precertification and retrospectivereview for medical necessity. Participates in continued stay reviews.Communicates with attending physician regarding questions about continuedlength of stay, plan of care/discharge, and physician orders.Refers appropriate cases to the designated Physician Advisor in accordancewith established guidelines for admission status or continued stay.Collaborates with case managers, physicians, and payers related tostatus, coverage, benefits, and di

DirectEmployers