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Added 30 mins ago
Senior Digital Product Manager (Ecommerce)
GCI Communication Corp
Anchorage, AK · AK
GCI's Senior Digital Product Manager will lead the definition and delivery of the Digital product vision and roadmap, ensuring components and platforms work together to support a wholistic…
Added 36 mins ago
Portfolio & Program Management Associate
Vertex Pharmaceuticals Incorporated
Boston, MA
The Associate Director (AD) of Portfolio and Program Management (PPM) sits within the COO's organization at Vertex and leads programs from Research through early Development. This role will…
Added 39 mins ago
W
Case Manager-Supportive Housing
Win
Corona, NY
- $26.37 USD / hour
The Case Manager – Supportive Housing provides comprehensive, trauma-informed case management services to families residing in permanent supportive housing. This position plays a critical…
Added 39 mins ago
W
Case Manager-Transitional Housing
Win
Staten Island, NY
- $26.76 USD / hour
Win is seeking a dedicated and compassionate Case Manager to support families residing in our Transitional Housing programs. In this role, you will provide comprehensive case management…
Added 39 mins ago
W
Case Manager-Transitional Housing
Win
Brooklyn, NY
- $26.76 USD / hour
Win is seeking a dedicated and compassionate Case Manager to support families residing in our Transitional Housing programs. In this role, you will provide comprehensive case management…
Added 40 mins ago
UO
State Anatomical Board Lab Professional
University of Colorado Denver
Aurora, CO
- $25 USD / hour
…administrativetasks related to the State AnatomicalBoard donor program. This position requiresadherenceto Anatomy Laboratory rules and regulations set by the Anatomy Lab…
Added 47 mins ago
W
Auto Care Center Service Manager
Walmart
HAZLEHURST, MS
- $19 to $32 USD / hour
…is a rewarding place to work with opportunities for advanced associate training, business development, and application of…
Added 48 mins ago
Project Coordinator/4078/Jackson
Terracon Consultants, Inc.
Jackson, MS
…registration setup as needed. Work with NAM to develop/maintain any Program Manual or related documents. Support project/program leadership with client communication plans. Maintain,…
Added 55 mins ago
Manager Lab Pre Analytics - Phlebotomy
Cleveland Clinic
United States
The Pre Analytics Manager will be responsible for all employment related activities to include recruitment and performance evaluations. This role will monitor budgets, fiscal performance,…
Added 1 hour ago
CS
Leasing Associate
Core Spaces
San Diego, CA
- $21.5 USD / hour
Founded in 2010, Core is a vertically integrated real estate investment manager focused on acquiring, developing and managing across the student housing and build-to-rent (“BTR”) sectors.…
Added 1 hour ago
Wine & Spirits Cashier
Festival Foods
Somers, WI
At Festival, people are at the top of our list. You’ll see it in everything from our daily interactions to how we treat our guests – even in our extensive associate benefits and programs.
Added 1 hour ago
IPS Analysis Chief (Associate Project Manager 2)
City of New York
Queens, NY
ONLY APPLICANTS PERMANENT IN THE CIVIL SERVICE TITLE OF ASSOCIATE PROJECT MANAGER WILL BE CONSIDERED***
Added 1 hour ago
Senior Estimator
City of New York
New York City, NY
Only candidates who are permanent in the Associate Project Manager title, reachable on DDC’s Promotional Exam #3573, or the Open Competitive Exam #3110 may apply. Please include a copy of…
Added 1 hour ago
Senior Project Manager
City of New York
New York City, NY
Only candidates who are permanent in the Associate Project Manager title, or reachable on the DDC Promotional list (exam #3573), or the Open-Competitive List (Exam #3110) may apply. Please…
Added 1 hour ago
Senior Project Manager
City of New York
New York City, NY
Only candidates who are permanent in the Associate Project Manager title, or those who are reachable on DDC’s promotional list for exam #3573 or the open-competitive list for exam #3110 may…
Added 1 hour ago
Senior Project Manager
City of New York
New York City, NY
Only candidates who are permanent in the Associate Project Manager title, or those who are reachable on DDC’s promotional list for exam #3573 or the open-competitive list for exam #3110 may…
Added 1 hour ago
Engineer-In-Charge
City of New York
New York City, NY
Only candidates who are permanent in the Associate Project Manager title, or those who are reachable on DDC’s promotional list for exam #3573 or the open-competitive list for exam #3110 may…
Added 1 hour ago
Operations Manager
City of New York
New York City, NY
The Operations Manager specific duties will include but are not limited to:
Added 1 hour ago
Director of Travel Services
City of New York
New York City, NY
…experience requiring independent decision-making concerning program management or planning, allocation for resources and the scheduling and assignment of work, 18 months of which must have…
Added 1 hour ago
ES
Assistant Store Manager
Extra Space Storage
Kingston, MA
- $17 to $20 USD / hour
The Assistant Store Manager plays a pivotal role in supporting the daily operations of one or more self-storage locations, under the guidance of the District Manager and Store Manager. This…
Added 1 hour ago
ES
Assistant Store Manager
Extra Space Storage
Pembroke, MA
- $17 to $20 USD / hour
The Assistant Store Manager plays a pivotal role in supporting the daily operations of one or more self-storage locations, under the guidance of the District Manager and Store Manager. This…
Added 1 hour ago
ES
Assistant Store Manager
Extra Space Storage
Pembroke, MA
- $18 to $20 USD / hour
The Assistant Store Manager plays a pivotal role in supporting the daily operations of one or more self-storage locations, under the guidance of the District Manager and Store Manager. This…
Added 1 hour ago
OR
Wireless Retail Sales Associate - W2184
OSL Retail Services
SEEKONK, MA
- $19 USD / hour
Benefit from sales incentives, career development opportunities, and an employee referral program.
Added 1 hour ago
Retail Merchandising & Inventory Supervisor
Staples
Attleboro, MA
Full-time hours, generous paid time off, career development program and weekly pay
Added 1 hour ago
ES
Assistant Store Manager
Extra Space Storage
Taunton, MA
- $18 to $20 USD / hour
The Assistant Store Manager plays a pivotal role in supporting the daily operations of one or more self-storage locations, under the guidance of the District Manager and Store Manager. This…

Erlanger

Utilization Management, RN Team Leader - Certified

Erlanger Baroness Hospital Chattanooga, TN, United States

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Job details

Experience: Required: 10 years of nursing experience including a broad range of both clinical nursing and utilization review and/or case management experience.
Posting language: English

Original job description

Job Summary:

The Utilization Review RN Team Lead Certified is a professional nurse employed by Erlanger Medical Center and is responsible for the support and adherence of day-to-day processes and responsibilities assigned to a team of Utilization Review RNs. Responsibilities include the design and implementation of an educational program based on nationally accepted best practices and organizational needs that includes training of new and existing UR nurses along with an auditing process to identify on-going educational needs. The incumbent acts as a liaison between Utilization Review staff, Case Management staff, physicians, Patient Financial Services staff and insurance representatives to ensure bedded patients are in the appropriate admission status and are approved by their payer for the care provided to them by Erlanger's clinical staff. This position is also responsible for overseeing communications between the Utilization Review RN staff and Case Management staff to identify patient's potential discharge readiness. Incumbent may also be asked to represent the department in meetings or committees where the Utilization Review Department has an impact.

This position is responsible for the assignment of and coordination of daily assignments for their team of Utilization Review RN�s and may include covering a section of patients in the event of staffing shortages. This position monitors and oversees the documentation adherence of their assigned staff to department processes and policies. They will serve as an educational resource for other Utilization Review teams, support staff, and physicians regarding insurance requirements along with being an education resource for both Milliman and InterQual criteria. This position reports to the Manager, Utilization Review.

Education:

Required: Graduate from an accredited school with an Associate's Degree in Nursing (RN).

Preferred: Graduate from an accredited school with Bachelor of Nursing (BSN), Masters of Nursing, Healthcare Administration or Business.

Experience:

Required: 10 years of nursing experience including a broad range of both clinical nursing and utilization review and/or case management experience. Demonstrated ability to work effectively with professionals in diverse disciplines. Must be computer literate and demonstrate ability to prioritize tasks and timeframes. Experience in and ability to coach, teach and manage individuals that utilize different learning mechanisms to assist them to reach their maximum potential.

Preferred: Knowledge of managed care practices and familiarity with regulatory and insurance reimbursement issues.

Position Requirement(s): License/Certification/Registration Required: Current licensure to practice nursing in the State of Tennessee (RN). Certified in Milliman and or InterQual Utilization Management or required to complete certification within one from hire date.

The Nurse Licensure Compact will not change how to obtain or renew a Tennessee license. However, the Tennessee nursing license will be a single state license for Tennessee Residents or non-compact state residents. Tennessee licensure or multistate licensure from a compact state must be obtained within three months of hire for non-Tennessee residents.

Department Position Summary:

The Utilization Review Team Lead Certified is a professional nurse employed by Erlanger Medical Center and is responsible for the oversight, support and day-to-day processes and responsibilities of a team of Utilization Review RNs. Responsibilities include the design and implementation of an educational program based on nationally accepted best practices and organizational needs that includes training of new and existing UR nurses along with an auditing process to identify educational needs, The incumbent acts as a liaison between Utilization Review staff, Case Management staff, physicians, Patient Financial services staff and insurance representatives to ensure bedded patients are in the appropriate admission status and are approved by their payer for the care provided to them by Erlanger's clinical staff. This position is also responsible for overseeing communications between the Utilization Review RN staff and Case Management staff to identify patient's potential discharge readiness. Incumbent may also be asked to represent the department in meetings or committees where the Utilization Review Department has an impact.

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