Rn Mgr Utilization Mgmt

Direct Staffing Inc · Hanover, MD, United States

Company

Direct Staffing Inc

Work style

Onsite

Employment

Full Time

Location

Hanover, MD, United States

Published

2015-04-14

Source checked

2026-09-16

Listing source

SmartRecruiters Posting API

About this role

Company Description Hosp Job Description Rn Mgr Utilization Mgmt Hanover, MD Exp 5-7 yrs Deg Bach Bonus Job Description Responsible for providing clinical supervision to a team responsible for coordinating member service, utilization, access, and concurrent review to ensure cost effective utilization of health, mental health, and substance abuse services. Primary duties may include, but are not limited to: Manages and oversees team responsible in case finding and coordinating cases that involve comorbid conditions. Coordinates service delivery to include member assessment of physical and psychological factors. Partners with providers to establish short and long term goals that meet the members needs, functional abilities, and referral sources requirements. Identifies members with potential for high risk complications. Reviews benefit systems and cost benefit analysis. Evaluates medical, mental health and substance abuse service for cost containment. Hires, trains, coaches, counsels, and evaluates performance of direct reports. Qualifications Requires a BA/BS; 5 years of experience in Health Care Management; or any combination of education and experience, which would provide an equivalent background. We need an aggressive UM manager quick with acute inpatient services including NICU, ICU, CCU and Transplants . We need current high volume experience with Maryland hospitals, on straight medical conditions. -Current unrestricted RN license in the state of Maryland required. -Prior managed care or insurance experience preferred. -Computer literate - MS Word, Excel, Outlook -Knowledge of Milliman or Interqual criteria preferred -Prior experience managing clinical staff required. IDEAL CANDIDATE Requires a BA/BS; 5 years of experience in Health Care Management; or any combination of education and experience, which would provide an equivalent background. Current unrestricted RN license in the state of Maryland required. Prior managed care or insurance experience preferred. Computer literate - MS Word, Excel, Outlook Knowledge of Milliman or Interqual criteria preferred Prior experience managing clinical staff required. Additional Information All your information will be kept confidential according to EEO guidelines. Direct Staffing Inc

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