- Lead and mentor a team of UM Nurses performing UM activities for Patients identified as having the need for Inpatient Care and/or Outpatient procedures, Inpatient Rehabilitation Facility or Long Term Acute Care Hospital (IPR/LTAC), Transplants, or Skilled Nursing Care, ensuring high UM program performance and quality outcomes of the Team
- Conduct regular audits and assessments of UM Nurses to ensure quality outcomes
- Track, monitor, and communicate trends in Key Performance Indicators and identify drivers and roadblocks to high-quality of care
- Collaborate with cross functional teams to identify and resolve challenges and coordinate activities
- Conduct regular meeting with internal and external stakeholders (e.g., payers, hospitals, SNFs, providers) to discuss UM improvement initiatives and progress
- Stay updated with industry regulations, guidelines, and best practices to ensure compliance and drive continuous improvement
- Responsible for obtaining EMR access to all the participating hospitals and maintaining relationships with all the hospitalist and hospitalist groups
- Assist with the preparation of department dashboards and reports
- Perform employee performance reviews
- Participate in the development and implementation of departmental Playbooks, and monitor/ensure compliance and consistency; review and revise workflows to ensure maximization of resources
- Other duties as assigned
- A bachelor's degree in Nursing or related medical field
- Proof of successful completion of educational requirements for a Nurse as defined by the state of Florida, as well as, proof of such licensure in good standing
- Licensure to be obtained for additional states or territories as required
- 3+ years of UM experience
- Complex Case Management (CCM) certification is a plus
- Minimum of 2 years leadership/management experience
- Proven success working with interdisciplinary teams
- Proficient with Google Suite (Drive, Docs, Sheets, Slides) and Microsoft Office (Word, Excel, PowerPoint) for real-time collaboration
- Ability to remain in a stationary position, often standing or sitting for prolonged periods of time
- Communicating with others to exchange information
- Repeating motions that may include the wrist, hands, and/or fingers
- Must be able to lift at least 15 lbs at times
- Ability to operate a motor vehicle
- Has a contagious and positive work ethic, inspires others, and models the behaviors of core values and guiding principles
- An effective team player who contributes valuable ideas and feedback and can be counted on to meet commitments
- Is able to work within our Better Health environment by facing tasks and challenges with energy and passion
- Pursues activities with focus and drive, defines work in terms of success, and can be counted on to complete goals
- Demonstrated ability to handle data with confidentiality
- Ability to work cross-functionally with multiple teams; ability to work independently with minimal supervision
- Excellent organizational, time-management, and multi-tasking skills with strong attention to detail
- Excellent written and verbal communication skills; must be comfortable communicating with senior-level leadership, providers, and health plans
- Strong interpersonal and presentation skills
- Strong critical thinking and problem-solving skills
- Must be results-oriented with a focus on quality execution and delivery
- Appreciation of cultural diversity and sensitivity toward target patient populations
-
Nurse Manager
3 weeks ago
Tampa Family Health Centers Tampa, United StatesJob Description · Job DescriptionAre you ready to embark on a career journey that's more than just a job? At Tampa Family Health Centers (TFHC), we're redefining healthcare, and looking for Nurse Manager to be part of our dynamic team. · We're not just a healthcare organization; ...
-
Nurse Manager
3 weeks ago
Tampa Family Health Centers Tampa, United StatesJob Description · Job DescriptionAre you ready to embark on a career journey that's more than just a job? At Tampa Family Health Centers (TFHC), we're redefining healthcare, and looking for a Nurse Manager - LPN to be part of our dynamic team. We're not just a healthcare organiza ...
-
Registered Nurse-Nurse Manager
1 week ago
Department of Veterans Affairs Tampa, FL, United StatesRegistered Nurse-Nurse Manager (SCI-Outpatient/Homecare) · Summary · The Nurse Manager has key leadership role within the Nursing Service and reports directly to the Chief Nurse of Spinal Cord Injury and Disorder (SCI/D) Nursing Department, through to the Associate Director for P ...
-
Nurse Manager
1 week ago
AdventHealth Tampa, United States**All the benefits and perks you need for you and your family:** · Paid Days Off from Day One · Student Loan Repayment Program · Career Development · Whole Person Wellbeing Resources · Mental Health Resources and Support**Our promise to you:**Joining AdventHealth is about being p ...
-
Assistant Nurse Manager
3 weeks ago
BayCare Health System Tampa, United StatesTitle: Assistant Nurse Manager - Medical/Surgical Neuro · "We dedicate our lives to caring for yours" · Position Description: RN · BayCare Health System is currently seeking a Registered Nurse to join our outstanding and compassionate Med/Surg Neuro team at St. Joseph's Hospi ...
-
CVOR Nurse Manager
2 weeks ago
AdventHealth Tampa Tampa, United StatesJob Description · All the benefits and perks you need for you and your family: · Benefits from Day One · Paid Days Off from Day One · Student Loan Repayment Program · Career Development · Whole Person Wellbeing Resources · Mental Health Resources and Support · Our promise to you: ...
-
Nurse Manager Cardiovascular Operating Room
2 weeks ago
AdventHealth Tampa, United StatesDetails Salary: Open · Categories: · General Nursing Internal Number: · Description · All the benefits and perks you need for you and your family: · Benefits from Day One · Paid Days Off from Day One · Student Loan Repayment Program · Career Development · Whole Person We ...
-
MDS Manager SNF RN Registered Nurse
3 weeks ago
Connect Senior Care Tampa, United StatesConnect Senior Care - Looking for a fresh start? · We are in need of FT a highly proficient , experienced Clinical Reimbursement Manager · OFFERING; · GREAT BENEFITS · FLEXIBLE WORK HOURS · REFERRAL BONUS PROGRAM · APPLY NOW · Clinical Reimbursement Manager/ Resident Assessment ...
-
Inpatient Care Management Nurse FL Market
6 days ago
UnitedHealth Group Tampa, United States Full timeOptum is a global organization that delivers care, aided by technology to help millions of people live healthier lives. The work you do with our team will directly improve health outcomes by connecting people with the care, pharmacy benefits, data and resources they need to feel ...
-
Registered Nurse Care Manager
15 hours ago
AdventHealth Tampa, United StatesAll the benefits and perks you need for you and your family: · Paid Days Off from Day One · Student Loan Repayment Program · Career Development · Whole Person Wellbeing Resources · Mental Health Resources and Support · Our promise to you: · Joining AdventHealth is about being par ...
-
Nurse Manager Cardiac Interventional
6 days ago
AdventHealth Tampa, United States**All the benefits and perks you need for you and your family:** · Paid Days Off from Day One · Student Loan Repayment Program · Career Development · Whole Person Wellbeing Resources · Mental Health Resources and Support**Our promise to you:**Joining AdventHealth is about being p ...
-
Assistant Nurse Manager ICU Medical Night
1 week ago
AdventHealth Tampa, United StatesDetails Salary: Open · Categories: · General Nursing Internal Number: · All the benefits and perks you need for you and your family: · Benefits from Day One · Student Loan Repayment Program · Career Development · Sign-on Bonus* · Our promise to you: · Joining AdventHealth ...
-
Nurse Manager
3 weeks ago
The Crisis Center Of Tampa Bay Tampa, United StatesSince 1972, the Crisis Center of Tampa Bay has been committed to bringing help, hope and healing to people facing serious life challenges. What we do and how we do it has changed dramatically over the years—and it will continue to evolve—but there is one thing that has never chan ...
-
Nurse Manager Cardiovascular Operating Room
1 week ago
AdventHealth Tampa Tampa, United States*All the benefits and perks you need for you and your family:* · * Benefits from Day One · * Paid Days Off from Day One · * Student Loan Repayment Program · * Career Development · * Whole Person Wellbeing Resources · * Mental Health Resources and Support · *Our promise to ...
-
Registered Nurse-Nurse Manager
2 weeks ago
Department of Veterans Affairs Tampa, FL, United StatesRegistered Nurse-Nurse Manager (SCI-Outpatient/Homecare) · The Nurse Manager has key leadership role within the Nursing Service and reports directly to the Chief Nurse of Spinal Cord Injury and Disorder (SCI/D) Nursing Department, through to the Associate Director for Patient Car ...
-
Telephonic Nurse Case Manager II
2 weeks ago
Elevance Health Tampa, United States"Telephonic" Nurse Case Manager II · Location: This is a virtual position. Candidates must reside within 50 miles of an Elevance Health Pulse Point location. · Hours: Monday - Friday 9:00am to 5:30pm EST and 1 late evening 11:30am to 8:00pm EST. · This position requires an on-lin ...
-
Sr Utilization Management Nurse RN
1 week ago
UnitedHealth Group Inc Tampa, FL, United StatesSr Utilization Management Nurse RN - Remote Nationwide · Optum is a global organization that delivers care, aided by technology to help millions of people live healthier lives. The work you do with our team will directly improve health outcomes by connecting people with the care ...
-
Transplant Nurse Case Manager RN
2 weeks ago
UnitedHealth Group Inc Tampa, FL, United StatesTransplant Nurse Case Manager RN - Remote · Optum is a global organization that delivers care, aided by technology to help millions of people live healthier lives. The work you do with our team will directly improve health outcomes by connecting people with the care, pharmacy ben ...
-
Registered Nurse Manager Pre-Surgery RN
2 weeks ago
AdventHealth Tampa Tampa, United StatesJob Description · All the benefits and perks you need for you and your family: · Paid Days Off from Day One · Student Loan Repayment Program · Career Development · Whole Person Wellbeing Resources · Mental Health Resources and Support · Our promise to you: · Joining AdventHealth ...
-
CenterWell Home Health Tampa, United StatesBecome a part of our caring community and help us put health first · The Manager Utilization Management Nursing utilizes clinical nursing skills to support the coordination, documentation and communication of medical services and/or benefit administration determinations. The Mana ...
Utilization Management Nurse Manager - Tampa, United States - Better Health Group
Description
Job Description
Job DescriptionOur mission is Better Health. Our passion is helping others.What's Your Why?
• Are you looking for a career opportunity that will help you grow personally and professionally?
• Do you have a passion for helping others achieve Better Health?
• Are you ready to join a growing team that shares your mission?
Why Join Our Team: At Better Health Group, it's our commitment, our passion, and our culture that sets us apart. Our Team Members make a difference each and every day They support our providers and payors, ensuring they have the necessary tools and resources to always deliver best-in-class healthcare experiences for our patients. We don't just talk the talk - we believe in it and live by it. Be part of a team that shares your passion and drive, and start living your purpose at Better Health Group.
Position Objective:
The Utilization Management (UM) Nurse Manager oversees and monitors the organization's UM functions. The goal is to achieve clinical, financial, and utilization goals by focusing on UM program performance and outcomes. The UM Nurse Manager manages daily UM operations of the UM Nurses. The incumbent will report to the Vice President, Health Services Operations.
Responsibilities:
Position Requirements/ Skills:
Physical Requirements:
Key Attributes/ Skills:
Powered by JazzHR
XyWHTMiGiq
