What are the responsibilities and job description for the Manager Utilization Management (System) position at UnityPoint Health?
Overview
The System Manager serves as leader for the Utilization Management processes at UnityPoint Health. The role is responsible for staff management, operational process oversight, and support to deliver positive outcomes that support both patient care and the financial health of the affiliate.
Why UnityPoint Health?
- Commitment to our Team – We’ve been named a Top 150 Place to Work in Healthcare 2022 by Becker’s Healthcare for our commitment to our team members.
- Culture – At UnityPoint Health, you matter. Come for a fulfilling career and experience a culture guided by uncompromising values and unwavering belief in doing what's right for the people we serve.
- Benefits – Our competitive Total Rewards program offers benefits options that align with your needs and priorities, no matter what life stage you’re in.
- Diversity, Equity and Inclusion Commitment – We’re committed to ensuring you have a voice that is heard regardless of role, race, gender, religion, or sexual orientation.
- Development – We believe equipping you with support and development opportunities is an essential part of delivering a remarkable employment experience.
- Community Involvement – Be an essential part of our core purpose—to improve the health of the people and communities we serve.
Visit us at UnityPoint.org/careers to hear more from our team members about why UnityPoint Health is a great place to work. https://dayinthelife.unitypoint.org/
Responsibilities
Management
- Directs, supervises, and coordinates day-to-day operations of department to accomplish department objectives.
- Maintains open communication among clinical service lines, medical staff, nursing staff, other personnel, patients, families, and the public, promoting a positive perception of patient care.
- Investigates barriers and problem areas to resolution, leading to a successful outcome.
- Addresses length of stay issues and level of care changes for compliance.
Department Support
- Collaborates with Revenue Cycle, Care Management, Physician Advisors, Medical Directors, Centralized Denials Team, etc.
Financial Support
- Develops annual departmental budget; monitors expenditures and manages resources to meet quality and financial goals.
Qualifications
Minimum Requirements
Identify items that are minimally required to perform the essential functions of this position.
Education:
BSN
Experience:
· Three (3) years of clinical experience in focused areas working with multidisciplinary teams. Previous experience in leadership position highly desirable
License(s)/Certification(s):
· Licensed Registered Nurse.
· Certification in a health care-related specialty as appropriate.
· Valid driver’s license when driving any vehicle for work-related reasons.
Knowledge/Skills/Abilities:
· Strong communication skills. Ability to set priorities; schedule and perform duties on a timely basis. Ability to work efficiently with frequent interruptions, deadlines and in a team environment.
· Knowledge and experience withMedicare, Medicaid, and Commercialpayor hospital surveys
· Broad knowledge of regulatoryenvironment and Medicare andMedicaid guidelines
· Knowledge ofreimbursement systems, federal, state,and payer specific regulations andpolicies pertaining to documentationand Utilization Management
· Proficiency in Microsoft Office and Excel
Other:
· Use of usual and customary equipment used to perform essential functions of the position.
· Work may occasionally require travel toother UPH facilities. May drive a UPHvehicle, rental, or own vehicle
