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Weekend Supervisor Utilization Management Jobs in Washington

Luminis Health

Utilization Management Nurse

Annapolis, MD · On-site

$34 - $55/hr

Monitors and identifies patterns or trends in utilization management; monitors potential and actual ... supervisor may assign other duties as deemed necessary. Pay Range $34-$55 USD Luminis Health ...

Bartholomew House

Weekend Supervisor

Bethesda, MD · On-site

$18 - $23/hr

Address concerns immediately with resident or care manager and handle appropriately or refer to the Executive Director. Notify the Executive Director immediately following any concern or incident.

Bartholomew House

Weekend Supervisor

Bethesda, MD · On-site

$18 - $23/hr

Address concerns immediately with resident or care manager and handle appropriately or refer to the Executive Director. Notify the Executive Director immediately following any concern or incident.

MedStar Health

RN Team Lead Utilization Review

Clinton, MD · On-site

$89K - $162K/yr

Candidate must live in the DC/Baltimore region General Summary of Position Supervises the daily activities of the Utilization Review Team. Manages daily assignment ensuring all UM tasks are completed ...

MedStar Health

Director Case Management

Columbia, MD · On-site

Supervises and develops manager and supervisors ensuring strong leadership cascade and ... Prior experience collaborating with Utilization Management Pharmacy Quality and Provider Relations ...

Adelphi Nursing and Rehabilitation Center

RN

Adelphi, MD

$19.50 - $21/wk

RN Supervisor Full-time RN Weekend Supervisor The Registered Nurse Weekend Supervisor would be responsible for supervising the day-to-day nursing activities of the facility during your tour of duty ...

Vita Healthcare Group

RN

Hyattsville, MD · On-site

RN Supervisor Full-time RN Weekend Supervisor The Registered Nurse Weekend Supervisor would be responsible for supervising the day-to-day nursing activities of the facility during your tour of duty ...

Vita Healthcare Group

RN

Adelphi, MD · On-site

$39 - $42/hr

) RN Supervisor Full-time RN Weekend Supervisor The Registered Nurse Weekend Supervisor would be responsible for supervising the day-to-day nursing activities of the facility during your tour of duty ...

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Weekend Supervisor Utilization Management information

What are the primary challenges a Weekend Supervisor in Utilization Management faces, and how can they be addressed?

Weekend Supervisors in Utilization Management often encounter challenges such as limited staff availability, high patient volume, and the need for rapid decision-making with less direct access to physicians or ancillary services. To address these, strong organizational skills, proactive communication, and the ability to prioritize urgent cases are essential. Supervisors should foster a collaborative atmosphere, leverage digital tools for efficient workflow, and ensure clear escalation protocols for complex cases, all while maintaining regulatory compliance and quality patient care.

What are the key skills and qualifications needed to thrive as a Weekend Supervisor Utilization Management, and why are they important?

To thrive as a Weekend Supervisor Utilization Management, you need a comprehensive understanding of clinical guidelines, utilization review processes, and healthcare regulations, typically supported by a nursing degree (RN) or related clinical licensure. Familiarity with utilization management software, electronic health records (EHRs), and knowledge of relevant accreditation standards (such as URAC or NCQA) are essential. Strong leadership, decision-making, and effective communication skills help navigate team dynamics and complex case reviews during weekend shifts. These skills ensure efficient resource management, compliance with healthcare standards, and consistent quality of care even outside regular business hours.

What is the difference between Weekend Supervisor Utilization Management vs Weekend Utilization Review Coordinator?

AspectWeekend Supervisor Utilization ManagementWeekend Utilization Review Coordinator
CredentialsTypically requires a healthcare-related license or certification (e.g., RN, LPN, or case management certification)Often requires similar healthcare credentials, such as RN or case management certification
Work EnvironmentSupervises utilization management staff, oversees case reviews, and ensures compliance during weekendsPerforms case reviews, evaluates medical necessity, and coordinates utilization decisions during weekends
Employer & IndustryHospitals, insurance companies, healthcare organizationsHospitals, insurance providers, healthcare organizations

The main difference is that the Weekend Supervisor Utilization Management role involves supervising staff and managing utilization processes, while the Weekend Utilization Review Coordinator focuses on conducting case reviews and making utilization decisions during weekends. Both roles require healthcare credentials and operate within similar environments, but their responsibilities differ in scope and leadership level.

What does a Weekend Supervisor in Utilization Management do?

A Weekend Supervisor in Utilization Management oversees the review and coordination of patient care services during weekends to ensure appropriate use of healthcare resources. They manage a team of utilization review staff, ensure compliance with policies, and facilitate communication between healthcare providers and insurance companies. Their role is critical in making timely decisions about patient admissions, continued stays, and discharges, focusing on quality care and cost efficiency. They also handle escalations and provide support to staff working outside of regular business hours.
What are popular job titles related to Weekend Supervisor Utilization Management jobs in Washington? For Weekend Supervisor Utilization Management jobs in Washington, the most frequently searched job titles are:
What job categories do people searching Weekend Supervisor Utilization Management jobs in Washington look for? The top searched job categories for Weekend Supervisor Utilization Management jobs in Washington are:
What cities in Washington are hiring for Weekend Supervisor Utilization Management jobs? Cities in Washington with the most Weekend Supervisor Utilization Management job openings:
Weekend Supervisor Utilization Management jobs near you
Utilization Management Nurse

Utilization Management Nurse

Luminis Health

Annapolis, MD • On-site

$34 - $55/hr

Full-time

Medical, Dental, Vision, Life, Retirement, PTO

Posted 6 days ago

Luminis Health rating

8.1

Company rating: 8.1 out of 10

Based on 52 frontline employees who took The Breakroom Quiz

68th of 886 rated healthcare providers

Job description

Position Objective: Conducts concurrent and retrospective chart review for clinical, financial, and resource utilization information. Provides intervention and coordination to decrease avoidable delays and denial of payment.
Essential Job Duties:
1. Chart Review:
Reviews the medical record by applying utilization review criteria, to assess clinical, financial, and resource utilization; enters clinical review in EPIC; maintains close communication with external reviews, care coordinators, and providers; reconciles and records days authorized in EPIC
2. Denial Management:
Monitors and identifies patterns or trends in utilization management; monitors potential and actual denials and collaborates with care coordinator for any follow up necessary; documents actions taken to avoid denial; assists Care Coordinator in communicating with the patient denied hospital days with work toward resolution and discharge.
3. Care Coordination:
Collaborates with the Care Coordinator to achieve optimal and efficient patient outcomes while decreasing length of stay, avoidable delays and denied days; utilizes Physician Advisor and administrative personnel for unresolved issues; identifies opportunities for expedited appeals and collaborates with the care coordinator and Physician Advisor to resolve payer issues.
4. Process improvement initiatives
Participates in nursing unit and department clinical outcome projects as well as process improvement initiatives of care management.
Educational/Experience Requirements:
  • Bachelor's of Science in Nursing or Associate's degree in Nursing with equivalent experience. BSN must be achieved within 5 years of start date in the role.
  • Three years of clinical nursing in an acute care hospital setting.

RequiredLicense/Certifications:
  • Current RN license from Maryland Board of Nursing.

Working Conditions, Equipment, Physical Demands:
There is a reasonable expectation that employees in this position will be exposed to blood-borne pathogens.
Physical Demands -
The physical demands and work environment that have been described are representative of those an employee encounters while performing the essential functions of this position. Reasonable accommodations may be made to enable individuals with disabilities to perform the essential functions in accordance with the Americans with Disabilities Act.
The above job description is an overview of the functions and requirements for this position. This document is not intended to be an exhaustive list encompassing every duty and requirement of this position; your supervisor may assign other duties as deemed necessary.
Pay Range
$34-$55 USD
Luminis Health Benefits Overview:• Medical, Dental, and Vision Insurance
• Retirement Plan (with employer match for employees who work more than 1000 hours in a calendar year)
• Paid Time Off
• Tuition Assistance Benefits
• Employee Referral Bonus Program
• Paid Holidays, Disability, and Life/AD&D for full-time employees
• Wellness Programs
• Employee Assistance Programs and more
*Benefit offerings based on employment status
Opt-in for text notifications!Luminis Health's two-way SMS texting platform lets you receive notifications and messages from our Talent Acquisition team directly on your phone.
To enable this feature, select "yes" when asked to "opt-in to receive text messages" and to "Receive updates from a recruiter about this job via SMS" when completing your application. Once you are opted in, you can easily opt-out at any time. Standard text messaging rates may apply based on the candidate's mobile carrier plan. Luminis Health is not responsible for any charges incurred by the recipient. Candidates are encouraged to review their mobile carrier's plan for applicable text messaging rates and usage charges.

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