Evening Optum Utilization Review Jobs in Spring, TX

Explore opportunities with Kelsey-Seybold Clinic, part of the Optum family of businesses. Work with one of the nation's leading health care organizations and build your career at one of our 40+ locations throughout Houston. Be part of a team that is nationally recognized for delivering coordinated and accountable care. As a multi-specialty clinic, we offer care from more than 900 medical providers in 65 medical specialties. Take on a rewarding opportunity to help drive higher quality, higher patient satisfaction and lower total costs. Join us and discover the meaning behind Caring. Connecting. Growing together.

• Manages activities of multiple supervisors in their respective areas of medical imaging relative to KSC standards, policies and procedures. Capable of functioning as a working manager when necessary. Maintains a working knowledge of PACS, IDXRAD, and BAR interfaces. Works effectively with IT representatives to identify and/or resolve issues
• Evaluates equipment service records, physicist reports and compliance documents prepared by the Medical Imaging supervisors and Quality Assurance specialist Assists supervisors in researching complex issues pertaining to image quality and confirms resolution. Responsible for compliance with applicable accreditation and regulatory bodies as well as associated documentation. Makes said documents available for review by ACR and other regulatory agencies and/or accreditation agencies.
• Assists Director and Department Chief with analyses of equipment and sites for expansion and enhancement of imaging services. Serves as primary contact person for such projects, completing project requests and delegating duties to affected departments as required by specific project. Provides input to Director and Department Chief for the development of both operating and capital budgets and is responsible for providing director with justifications for budget variances
• Works closely with the Coding and Compliance department. Seeks opportunities to improve CPT and ICD9 coding practices across all modalities in accordance with correct coding initiatives. Upon the annual receipt of new CPT codebook, review for changes in radiology coding and implement those changes after receiving approval from the coding and compliance department. Conducts annual charge master review to confirm that procedure codes accurately reflect protocols. Verifies that services received by the patient are correctly reflected on the statement via periodic auditing of actual patient accounts and subsequent reports to the director.
• Supports supervisors in their selection of candidates for hiring and disciplinary actions. The Radiology Department manager is the management level representative for verbal and written counseling sessions and is the 2nd level management approval on performance appraisals. Mentors supervisors and actively contributes to their professional development as well as the professional development of other members of the department. Works with supervisors to establish and maintain departmental participation and compliance in safety initiatives. Conducts staff meetings and trainings and delegates those duties where appropriate
• Responsible for follow up and resolution of patient, physician, and staff complaints as well as complaints arising from other departments that are not resolved at the supervisor level. Identifies customer service level indicators, establishes benchmarks, monitors performance and prepares quantitative reports that reflect those service levels. Interacts positively with other Clinic departments, physicians, and staff as well as entities outside the Clinic
• Reviews clinical and clerical competencies for all areas of responsibility and confirms that competency is commensurate with job description and that job descriptions are reviewed and current to reflect duties. Updates departmental policy and procedure manuals as changes occur and submits proposed changes to radiology director and Chief of Radiology for review and approval. In the absence of changes requiring updates, an annual review will be conducted and submitted for approval
• Manages personnel resources to provide adequate staffing at all times to meet demands without delaying patient care. Evaluates staffing models and makes recommendations for improvement. Aggressively seeks opportunities to improve efficiency and productivity. Coordinates with clinic administrators when evaluating peripheral staffing and carefully considers impact of staffing levels on the operation of individual clinics. Works closely with Human Resources to monitor effectiveness of compensation strategies and subsequent impact on recruitment and retention of staff
• Understands budgetary responsibilities and monitors supply utilization and costs. Works with the purchasing department to identify approved vendors in order to take advantage of discounts and/or buying promotions for capital items as well as supplies. Assists director in the monitoring of departmental resources, and evaluating service contract and equipment purchase parameters. Responsible for submitting proposed contracts and/or purchasing documents for legal review and follow through for approval process. Responsible for maintenance of existing equipment. Maintains current knowledge of equipment service contracts and evaluates invoices arising from service calls to be sure that invoices are in accordance with parameters of contracts
• In collaboration with Supervisors, Director and Department Chief, utilizes PDSA model to effect positive change on process and to determine annual departmental goals. Reviews department processes and workflow, assess impact on established goals and makes recommendations to director and Chief of Radiology for annual process improvements. Responsible for implementation and completion of a minimum of two process improvement plans annually as determined by the director and the Chief of Radiology

You'll be rewarded and recognized for your performance in an environment that will challenge you and give you clear direction on what it takes to succeed in your role as well as provide development for other roles you may be interested in.

• Bachelor's degree in Healthcare Sciences, Human Resources, or a related field
• Required licenses and certifications appropriate to the imaging modality and/or specialty of the incumbent
• Current Basic Life Support (BLS) certification through the American Heart Association
• 5+ years of progressive supervisory or management experience in medical imaging
• Experience managing teams of more than 10 employees across multiple imaging modalities and imaging-related clerical functions
• Knowledge of accreditation and regulatory requirements
• Working knowledge of CPT codes and reimbursement guidelines
• Solid computer skills with the ability to generate management reports
• Proven excellent interpersonal skills to support team development and cross-functional collaboration
• Demonstrated solid written and verbal communication skills
• Demonstrated ability to effectively manage multiple sites where imaging equipment is located

• Master's degree in Healthcare Sciences, Business Administration, Human Resources, or a related field
• ARRT (American Registry of Radiologic Technologists) RT Certification (General Certificate)
• Additional certifications in other imaging modalities
• PACS and RIS experience

Pay is based on several factors including but not limited to local labor markets, education, work experience, certifications, etc. In addition to your salary, we offer benefits such as, a comprehensive benefits package, incentive and recognition programs, equity stock purchase and 401k contribution (all benefits are subject to eligibility requirements). The salary for this role will range from $91,700 - $163,700 annually based on full-time employment. We comply with all minimum wage laws as applicable.

At UnitedHealth Group, our mission is to help people live healthier lives and make the health system work better for everyone. We believe everyone-of every race, gender, sexuality, age, location and income-deserves the opportunity to live their healthiest life. Today, however, there are still far too many barriers to good health which are disproportionately experienced by people of color, historically marginalized groups and those with lower incomes. We are committed to mitigating our impact on the environment and enabling and delivering equitable care that addresses health disparities and improves health outcomes - an enterprise priority reflected in our mission.

OptumCare is an Equal Employment Opportunity employer under applicable law and qualified applicants will receive consideration for employment without regard to race, national origin, religion, age, color, sex, sexual orientation, gender identity, disability, or protected veteran status, or any other characteristic protected by local, state, or federal laws, rules, or regulations.

OptumCare is a drug-free workplace. Candidates are required to pass a drug test before beginning employment.