The Supervisor of Utilization Management (UM) RN is responsible for executing the day-to-day operations of the UM department and monitoring the Care Management (CM) staff’s responsibilities and activities.
This includes, but is not limited to, ensuring proper staffing and coverage; monitoring and evaluating departmental operations to ensure optimal efficiency, productivity, and effectiveness; documenting and appropriately addressing excellence or deviations in work, departmental, and organizational expectations; and conducting intermittent and annual performance evaluations.
This role assists in triaging identified issues/problems and forming resolutions within the scope of work/licensure. The Supervisor is a subject matter expert (SME) in Care/Case/Utilization Management and supporting regulations, policies, protocols, and procedures.
This position serves as a formal and informal instructor and escalates issues/concerns to the appropriate person when outside of their scope. This position is responsible for assisting with the development and maintenance of a successful and cohesive unit, with a high level of productivity and accuracy to achieve the department's overall performance metrics.
The Supervisor ensures all functions of the UM department operate in accordance with the organization's mission, values, and strategic goals, which focus on quality care delivery and continuous improvement; and are provided in a manner that is responsive and sensitive to the …