RN Leader, Utilization Management & Clinical Appeals

Lifespan

Providence (RI)

Presencial

USD 98.000 - 195.000

Tempo integral

Há 6 dias

Seja uma das primeiras pessoas a se candidatar

Receba uma resposta desta empresa empregadora

Seu currículo e carta de apresentação personalizados exatamente para o que estão contratando.

Passe pelos filtros ATS

Resumo da vaga

Brown University Health is seeking a Senior Utilization Management Leader to direct UM nurses, payor liaisons, and preauthorization staff. You will guide orientation, education, and competency, and help shape departmental policies and budgets to support high-value patient-centered care.

Collaboration with the director and medical director will set priorities. The role requires RI RN licensure, a BSN, and strong communication skills; a Master's or related health discipline is preferred, with case

Qualificações

Must hold an active Rhode Island RN license.
Bachelor’s degree in nursing is required.
Master’s degree in nursing or another health discipline is preferred.
Familiarity with Rhode Island Nurse Practice Act is required.
Certification in case management is preferred.

Responsabilidades

Direct and develop utilization management nurses, payor liaisons, and preauthorization staff; oversee orientation, education, and competency assessment.
Partner with the Director to establish staff competency measures and orientation processes.
Develop departmental policies, plans, and budgets; align priorities with utilization management goals.
Identify institutional needs with the director and medical director; prioritize initiatives.
Manage resources to meet goals; serve as on-call resource for UM staff on weekends/holidays.