Utilization Management Director jobs in Pennsylvania

Penn State Health - Milton S. Hershey Medical Center

Location : US:PA: Hershey
Work Type : Full Time
FTE : 0.90
Shift : Day
Hours : 9:00a - 9:30p

SUMMARY OF POSITION :

Responsible for the review of clinical documentation in the Electronic Medical Record (EMR), comparing it to the nationally accepted and evidence-based criteria to certify an admission to the facility, and for concurrent/continued stay review as appropriate. Also responsible for maintaining compliance with the CMS Conditions of Participation for Utilization Management.

MINIMUM QUALIFICATIONS:

Bachelor's Degree in Nursing or Master's Degree in Nursing required 3 years

Advanced clinical experience in a hospital setting required.

Currently licensed to practice as a registered nurse by Pennsylvania Board of Nurse Examiners required.

Demonstrated ability to problem-solve complex, multidimensional situations required.

Ability to successfully manage conflict and negotiate "win-win" solutions required.

Strong organizational, task prioritization and delegation skills required.

Strong oral and written communication skills required.

Ability to work independently required.

PREFERRED QUALIFICATIONS:

Financial Counseling experience preferred.

This job description is a general outline of duties performed and is not to be misconstrued as encompassing all duties performed within the position. All individuals (including current employees) selected for a position will undergo a background check appropriate for the position's responsibilities.

Penn State Health is fundamentally committed to the diversity of our faculty and staff. We believe diversity is unapologetically expressing itself through every person's perspectives and lived experiences. We are an equal opportunity and affirmative action employer. All qualified applicants will receive consideration for employment without regard to age, color, disability, gender identity or expression, marital status, national or ethnic origin, political affiliation, race, religion, sex (including pregnancy), sexual orientation, veteran status, and family medical or genetic information. If you are unable to use our online application process due to an impairment or disability, please call 717-531-8440 between the hours of 7:30 AM and 4:30 PM, Eastern Standard Time, Monday through Friday, email hrsolutions@pennstatehealth.psu.edu or download our Accommodation Instructions for Job Applicants PDF for more detailed steps for assistance.

Union : SEIU Healthcare Pennsylvania