Job: System Director Utilization Review
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System Director Utilization Review
Department: Utilization Review -(LR)
The System Director of Utilization Review will directly report to the VP Revenue Cycle of Baptist Health. Bring Utilization Review leaders and staff together at a system level to achieve consistency in process and optimal results. Responsible for management, coaching and success of Utilization Review department employees. Educate, implement and follow the Utilization Review Status Determination plan. Audit staff status determination decisions on a weekly basis, reporting out results to key leaders. Develop supportive team relationships with other Revenue Cycle departments as well as other departmental partners. Working in conjunction with applicable system leaders, insure continued incremental improvement in financial results, patient and employee satisfaction, and governmental compliance. Work for compliance with all regulatory agencies that oversee our operations. Assist in the education and implementation of the EHR tool and program. Insure staff compliance with this new process. Demonstrate our values and integrity in all you do as a key representative of Baptist Health. Develop relationships with hospital leadership at each facility including reporting of results, recommendations for improvement, warnings of issues, etc.
*3-5 years management experience preferred in the field.
*Medicare status review experience preferred.