RN Manager, Utilization Management & Clinical Appeals

Brown University Health; Providence (RI); Presencial; USD 98.000 - 195.000; Tempo integral

Resumo da vaga

Brown University Health is seeking a capable leader to head the Utilization Management team at Rhode Island Hospital in Providence. The role focuses on guiding utilization management nurses, payor liaisons and preauthorization staff, while driving process improvements and policy development to support patient-centered care.

As a senior leader, you will implement competency programs, manage budgets, and collaborate with the medical director to align priorities with organizational goals.

Qualificações

• RN licensure in Rhode Island or eligibility
• Bachelor’s degree in nursing required
• Master’s degree in nursing or related health discipline preferred
• Knowledge of Rhode Island Nurse Practice Act
• Certification in case management preferred
• Five years clinical/utilization management leadership experience

Responsabilidades

• Provide leadership for utilization management nurses, payor liaisons and preauthorization staff
• Collaborate to develop staff competency measurements and orientation
• Develop departmental policies and strategic plans
• Identify institutional needs with director and medical director of utilization management
• Develop and manage budgets and staffing to support utilization management standards
• Be on-call resource for UM nurses on rotating weekends and holidays

Conhecimentos

Leadership

Staff management

Budgeting

Quality improvement

Communication

Formação

RN licensure Rhode Island

Bachelor’s degree in nursing

Master’s degree in nursing or related health discipline preferred

Descrição da vaga

Brown University Health is seeking a capable leader to head the Utilization Management team at Rhode Island Hospital in Providence. The role focuses on guiding utilization management nurses, payor liaisons and preauthorization staff, while driving process improvements and policy development to support patient-centered care.

As a senior leader, you will implement competency programs, manage budgets, and collaborate with the medical director to align priorities with organizational goals.