Director - Utilization Review
Company: Memorial Healthcare System
Location: Miramar
Posted on: October 20, 2024
Job Description:
Location:Miramar, FloridaAt Memorial, we are dedicated to
improving the health, well-being and, most of all, quality of life
for the people entrusted to our care. An unwavering commitment to
our service vision is what makes the difference. It is the
foundation of The Memorial Experience.Summary:Directs the
department's activities and resources to ensure alignment with the
mission, values, and objectives of the department and
organization.Responsibilities:Prepares and evaluates departmental
budgets, and ensures that the department operates in compliance
with allocated funding. Coordinates and directs internal/external
audits.Plans and monitors staffing activities, including hiring,
orienting, evaluating, disciplinary actions, and continuing
education initiatives.Manages and evaluates department operations,
including information technologies, service level determination and
complaint management, to achieve performance and quality control
objectives.Develops and implements departmental goals, plans, and
standards consistent with the clinical, administrative, legal and
ethical requirements of the organization.Works collaboratively with
other disciplines, physician liaison, and facility Directors of
Clinical Effectiveness to ensure that utilization review is
performed timely, accurately and in compliance with appropriate
regulatory bodies.Competencies:ACCOUNTABILITY, ANALYSIS AND
DECISION MAKING, CUSTOMER SERVICE, EFFECTIVE COMMUNICATION,
MANAGING BUDGETS - MANAGEMENT, MANAGING PEOPLE, RESPONDING TO
CHANGE, STANDARDS OF BEHAVIOREducation and Certification
Requirements:Accredited Program: Nursing (Required)Registered Nurse
License (RN LICENSE) - State of Florida (FL)Additional Job
Information:Complexity of Work: Requires critical thinking skills,
decisive judgment and the ability to work with minimal supervision.
Must be able to work in a stressful environment and take
appropriate action. Excellent interpersonal skills needed.Required
Work Experience: 5 years leadership experience and 2 years
experience in utilization case management.Working Conditions and
Physical Requirements:
- -Bending and Stooping = 60%
- -Climbing = 0%
- -Keyboard Entry = 80%
- -Kneeling = 40%
- -Lifting/Carrying Patients 35 Pounds or Greater = 0%
- -Lifting or Carrying 0 - 25 lbs Non-Patient = 60%
- -Lifting or Carrying 2501 lbs - 75 lbs Non-Patient = 0%
- -Lifting or Carrying > 75 lbs Non-Patient = 0%
- -Pushing or Pulling 0 - 25 lbs Non-Patient = 60%
- -Pushing or Pulling 26 - 75 lbs Non-Patient = 0%
- -Pushing or Pulling > 75 lbs Non-Patient = 0%
- -Reaching = 60%
- -Repetitive Movement Foot/Leg = 0%
- -Repetitive Movement Hand/Arm = 80%
- -Running = 0%
- -Sitting = 80%
- -Squatting = 40%
- -Standing = 80%
- -Walking = 80%
- -Audible Speech = 80%
- -Hearing Acuity = 80%
- -Smelling Acuity = 0%
- -Taste Discrimination = 0%
- -Depth Perception = 80%
- -Distinguish Color = 80%
- -Seeing - Far = 80%
- -Seeing - Near = 80%
- -Bio hazardous Waste = 0%
- -Biological Hazards - Respiratory = 0%
- -Biological Hazards - Skin or Ingestion = 0%
- -Blood and/or Bodily Fluids = 0%
- -Communicable Diseases and/or Pathogens = 0%
- -Asbestos = 0%
- -Cytotoxic Chemicals = 0%
- -Dust = 0%
- -Gas/Vapors/Fumes = 0%
- -Hazardous Chemicals = 0%
- -Hazardous Medication = 0%
- -Latex = 0%
- -Computer Monitor = 80%
- -Domestic Animals = 0%
- -Extreme Heat/Cold = 0%
- -Fire Risk = 0%
- -Hazardous Noise = 0%
- -Heating Devices = 0%
- -Hypoxia = 0%
- -Laser/High Intensity Lights = 0%
- -Magnetic Fields = 0%
- -Moving Mechanical Parts = 0%
- -Needles/Sharp Objects = 0%
- -Potential Electric Shock = 0%
- -Potential for Physical Assault = 0%
- -Radiation = 0%
- -Sudden Decompression During Flights = 0%
- -Unprotected Heights = 0%
- -Wet or Slippery Surfaces = 0%Shift:Primarily for office
workers - not eligible for shift differentialDisclaimer: This job
description is not intended, nor should it be construed to be an
exhaustive list of all responsibilities, skills, efforts or working
conditions associated with the job. It is intended to indicate the
general nature and level of work performed by employees within this
classification.Wages shown on independent job boards reflect market
averages, not specific to any employer. We encourage candidates to
talk to their Memorial Healthcare System recruiter to discuss
actual pay rates, during the hiring process.Memorial Healthcare
System is proud to be an equal opportunity employer committed to
workplace diversity.Memorial Healthcare System recruits, hires and
promotes qualified candidates for employment opportunities without
regard to race, color, age, religion, gender, gender identity or
expression, sexual orientation, national origin, veteran status,
disability, genetic information, or any factor prohibited by law.We
are proud to offer Veteran's Preference to former military,
reservists and military spouses (including widows and widowers).
You must indicate your status on your application to take advantage
of this program.Employment is subject to post offer, pre-placement
assessment, including drug testing.If you need reasonable
accommodation during the application process, please call
954-276-8340 (M-F, 8am-5pm) or email
TalentAcquisitionCenter@mhs.net
Keywords: Memorial Healthcare System, Doral , Director - Utilization Review, Executive , Miramar, Florida
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