Utilization Management Accountable for providing Degree in 7 Des Moines, Bachelor’s Manager vision and strategy for Nursing, Health IA inpatient utilization and Administration, Nutrition (Director, Utilization prior authorization or related field Management) management activities Unrestricted and current designed to achieve license in Iowa quality and service-driven Acute clinical or surgical objectives. Oversees all experience and/or phases of development, behavioral health clinical organization, planning and setting implementation of Managed care experience operations and projects to Experience in utilization enhance quality-driven management to include outcomes. Accountable pre-authorization, for a team of Iowa-based utilization review, UM nurses. Leverages concurrent review, review criteria and discharge planning, guidelines working in and/or skilled nursing partnership with the prior facility reviews authorization team in Tampa. Oversees onsite concurrent review in participating hospitals. Care Coordination Accountable for team of Degree in 7 Des Moines, Bachelor’s Manager community-based case Nursing or Health IA managers tasked the full Administration (Director, Case scope of case Management) Registered Nurse Clinical management, along with a Specialist (RNCS) team of field service Case management coordinators responsible experience for day-to-day care Managed care experience coordination. Management experience Behavioral Health Accountable for team of Master's Degree in 3 Des Moines, Manager behavioral health clinical social work, IA specialists. Works with psychology, counseling, (Senior Manager, the Case Management or rehabilitation (if Behavioral Care) team to ensure that LSCW) care is integrated Experience with direct into each care plan. patient care Clinical behavioral health services experience Utilization management experience
Utilization Management Manager (Director, Utilization Management) Accountable for providing vision and strategy for inpatient utilization and prior authorization management activities designed to achieve quality and service-driven objectives. Oversees all phases of development, organization, planning and implementation of operations and projects to enhance quality-driven outcomes. Accountable for a team of Iowa-based UM nurses. Leverages review criteria and guidelines working in partnership with the prior authorization team in Tampa. Oversees onsite concurrent review in participating hospitals. Bachelor’s Degree in Nursing, Health Administration, Nutrition or related field Unrestricted and current license in Iowa Acute clinical or surgical experience and/or behavioral health clinical setting Managed care experience Experience in utilization management to include pre-authorization, utilization review, concurrent review, discharge planning, and/or skilled nursing facility reviews 7 Des Moines, IA Care Coordination Manager (Director, Case Management) Accountable for team of community-based case managers tasked the full scope of case management, along with a team of field service coordinators responsible for day-to-day care coordination. Bachelor’s Degree in Nursing or Health Administration Registered Nurse Clinical Specialist (RNCS) Case management experience Managed care experience Management experience 7 Des Moines, IA Behavioral Health Manager (Senior Manager, Behavioral Care) Accountable for team of behavioral health specialists. Works with the Case Management team to ensure that care is integrated into each care plan. Master's Degree in clinical social work, psychology, counseling, or rehabilitation (if LSCW) Experience with direct patient care Clinical behavioral health services experience Utilization management experience 3 Des Moines, IA
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