Job Summary
ProgenyHealth is a company specializing in care management solutions for infants in intensive care nurseries. We partner with health plans and employer groups and their neonatal providers to work collaboratively in developing a plan of care specific to the needs of each child. We work with the plans' neonatal providers and families from the moment an infant is admitted to the intensive care nursery, until they are safely transitioned from the hospital through the first year of life.
Our culture and work environment promotes and inspires an active, continuous improvement philosophy in regard to products and services in line with our company mission statement which is as follows:
With passion and a singular focus, we improve the health outcomes of premature and medically complex newborns through provider collaboration and parental engagement.
The RN Utilization Management Supervisor, will primarily be responsible for managing the UM nursing staff in the day to day operations of the department. This includes oversight and adjustment of work queue's when needed to maintain work flow balance, monitoring and implementing adherence to department and company metrics, training of new hires and on-going clinical, managing staff to performance expectations for the department including coaching and counseling and various other responsibilities to support the clinical nursing staff and the company program. This role is expected to perform the role of the staff when necessary to maintain compliance with client or URAC requirements.
He/she 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 with regard to products and services in line with our company mission.
Qualifications
Registered Nurse (RN) with a current, unrestricted license is required.
Two or more years of experience in a Concurrent Review OR Case Management role required
Two or more years of experience in a health plan (managed care organization) required
Two or more years' experience in a supervisory role managing nursing staff within a Healthplan required
Three or more years of clinical experience as a bedside nurse in NICU/PICU/Peds or other Intensive care unit preferred.
Must be available to work late as needed to manage staff caseloads and project deadlines
Experience with URAC & NCQA 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.
