The Utilization Review Supervisor is responsible for the technical and clinical supervision of the Utilization Review department under the direction of the Director of Case Management.
The Utilization Review Supervisor will assist in planning, organizing and assist with supervising the unit staff, preparing the department for internal and external audits, and developing policies and procedures for adherence to government and accredited agency standards.
The Utilization Review Supervisor will oversee and participate in the development and implementation of effective and efficient standards, policies, protocols and reports that support and enhance utilization management and delivery of care.
EDUCATION: Graduate of an accredited program for Registered Nursing.
CERTIFICATION/LICENSES: RN with current New Mexico licensure
SKILLS: Strong leadership skills and previous supervisory experience includingexperience in facilitating interdisciplinary team collaboration. Evidence of such experience shouldinclude:
Strong nursing knowledge and clinical skills
Effective communication skills (verbal and written)
Strong analytical skills
Ability to problem solve; ability to appropriately confront issues
Ability to motivate others as individuals and as a team
Ability to plan, organize, and manage the activities of others under the supervision of the Case management director
Ability to effectively run meetings and to negotiate deadlines.
Ability to communicate with a wide variety of audiences
Experience in dealing with physicians and able to workcollaboratively with medical staff members and leadership.
EXPERIENCE: Minimumof 5 years of case management experience, with emphasis on Utilization management. Supervisory experience preferred.
-Responsible to: Director of Case Management
Subject to stressful professional relationships. Working hours vary, with flexibility due to unexpected changes in schedule and emergencies. Requires the ability to speak, listen, develop and communicate written materials.
CHRISTUS HEALTH is an international Catholic, faith-based, not-for-profit health system comprised of almost more than 600 services and facilities, including more than 60 hospitals and long-term care facilities, 350 clinics and outpatient centers, and dozens of other health ministries and ventures. CHRISTUS operates in 6 U.S. states, Colombia, Chile and 6 states in Mexico. To support our health care ministry, CHRISTUS Health employs approximately 45,000 Associates and has more than 15,000 physicians on medical staffs who provide care and support for patients. CHRISTUS Health is listed among the top ten largest Catholic health systems in the United States.