Utilization Manager Jobs in Alabama (NOW HIRING)

USA Health is Transforming Medicine along the Gulf Coast to care for the unique needs of our community. USA Health is changing how medical care, education, and research impact the health of people who live in Mobile and the surrounding area. Our team of doctors, advanced care providers, nurses, therapists, and researchers provides the region's most advanced medicine at multiple facilities, campuses, clinics, and classrooms. We offer patients convenient access to innovative treatments and advancements that improve the health and overall well-being of our community.

• The Manager of Care Management, Ancillary Team professional responsibility within their scope of practice:
  • Abides by and enforces all compliance requirements and policies and performs these responsibilities in an ethical
  • manner consistent with the organization's values.
  • Adheres to hospital policies including confidentiality.
  • Requires regular and prompt attendance.
  • Works the assigned schedule including overtime as required.
• The Manager of Care Management patient care/department responsibilities:
  • Oversees Daily Operations of the Care Management Ancillary staff.
  • Addresses staff and leadership escalations/concerns timely.
  • Assist Manager-Care Management DCP with Shared Governance Committees based upon process improvement and
  • staff engagement.
  • Oversees the Development of the CM Ancillary Teams Orientation, Ongoing Education, and Annual Competency
  • Evaluations
  • Develops the clinical documentation system for the entire Care Management Team with collaboration from
  • leadership.
  • Supervises activities and functions related to ancillary team performance related discharge planning, utilization
  • management/ denials, department performance improvement, hospital committees, external and internal audits,
  • and accreditation, according to agency, hospital, and departmental guidelines.
  • Collects data monthly surrounding third party payer and managed care organizations related to discharge planning
  • needs, utilization management and post-acute placement/ services rendered.
  • Analyzes retrospective reviews and monthly reporting to ensure quality and productivity standards. Collaborates
  • with leadership to formulate plan to improve/ celebrate outcomes.
• The Manager of Care Management Ancillary Team communication responsibilities:
  • Communicates and uses appropriate customer relation skills with physicians, patients, families, and healthcare
  • team in person and via telephone.
  • Responds to overhead pages.
• The Manager of Care Management Ancillary Team documentation responsibilities:
  • Maintains accurate and complete records by in all areas requiring documentation, including by not hmited to:
  • Personnel records
  • Quality data
  • Committee records
  • Audit reports
• The Manager of Care Management Ancillary Team citizenship responsibilities:
  • Accepts and completes all duties positively and without conflict.
  • Cooperates, helps others, and improves the performance of the unit.
  • Completes all mandatory unit, educational and hospital requirements.
  • Utilizes cost effective practices in performing all aspects of the job.
  • Maintains orderliness and cleanliness of work areas, equipment, and supply areas.
  • Adheres to current Infection Control and Safety Standards.
• The Manager of Care Management responsibilities for providing age specific care:
  • Across the Continuum of life
• The Manager of Care Management responsibilities for unit/departmental specific:
  • Consistently fulfill job functions as listed in job description.
• OTHER DUTIES AND RESPONSIBILITIES: Other duties as assigned/required. Participates on committees as assigned.Participates in Performance Improvement activities through quality measurement or participation in PSCA process as assigned.
• Completes all mandatory department, educational and hospital requirements
• Adheres to current Infection Control and Safety Standards
• Regular and prompt attendance
• Ability to work schedule as defined and overtime as required
• Related duties as assigned

Employees must be in a regular position, working 20 hours or more per week (.50 FTE or greater) to qualify for benefits.

• Bachelor's Degree in Nursing or Social Work from an accredited institution as approved and accepted by the University of South Alabama and 3 years of related experience, one of which was in a leadership or managerial position. Required
• Licensure in the area of clinical focus. Required
• Comparable combination of education and experience may substitute for the above requirements.