Job Summary
ProgenyHealth is a leading provider of care management solutions for premature and medically complex newborns. We partner with health plans and their neonatal providers to work collaboratively in developing a plan of care specific to the needs of each child - from admission to the intensive care nursery until they are safely transitioned from the hospital, through the first year of life. Our program promotes appropriate utilization, improves access, educates family members, reduces costs, and improves outcomes.
Job Role
The Utilization Management Supervisor will primarily be responsible for managing the Utilization Management nursing staff in the day to day operations of the department. This includes oversight and adjustment of work queues, when needed, to maintain work flow balance; monitoring and implementing adherence to department and company metrics; training of new hires and on-going clinical; and various other responsibilities to support the clinical nursing staff and the company program. The incumbent will also be responsible for assessment of the UM program for opportunities to improve efficiencies and/or improve outcomes.
Reporting to the Director of Utilization Management, the Supervisor will work closely with the management staff and will play a key role in implementing the culture and work environment that promotes and inspires an active, continuous improvement philosophy regarding products and services in line with our company mission statement:
To improve the health outcomes of infants in intensive care nurseries through partnership, care
facilitation, continuous quality improvement and a firm commitment to excellence.
Qualifications
Registered Nurse (RN) with a current, unrestricted license is required.
Two or more years of experience in Managed Care, in a Utilization Review or Case Management role, is required.
Three or more years' experience in a supervisory role managing nursing staff is desired
Three or more years of clinical experience as a bedside nurse in NICU/PICU/Peds or other Intensive Care Unit is required.
Must be available to stay late as needed to manage staff and caseloads.
Experience with URAC standards preferred.
Must have demonstrated strong problem-solving skills.
Must have proven track record of utilizing tact, diplomacy and strategic thinking in addressing issues and changes in company policy, etc.
Must be self-motivated and willing to learn multiple tasks.
Must be well organized and able to prioritize tasks.
Must have good computer skills and be familiar with using Microsoft Office (Word, Outlook etc).
Must demonstrate accuracy in spelling and documentation.
Must have commitment to excellence in customer service.
Benefits/Culture
Our team is our most important asset. some of the benefits we offer our team are:
401K with company match
Medical and dental benefits
Long Term Disability
Paid Time Off
Business Casual Work environment
Team orientated events throughout the year
Role specific - partial or full telecommuting (after training period)
