Jobs
>
Fresno

    Utilization Management Manager - Fresno, United States - Medasource

    Medasource
    Medasource Fresno, United States

    3 weeks ago

    Default job background
    Description

    Job Title:

    Utilization Management ManagerLocation:
    Fresno, California (travel reimbursement if needed)

    Start Date:
    ASAPDuration:

    6-month contract or contract-to-hire

    Summary:

    Our premiere healthcare client is looking to bring in a Utilization Management Director to help with assigned departments and functions across the area continuum of care to provide integrated services in a fiscally responsible manner through direction, support, and development of administrative staff, and community groups and agencies.

    In addition, individual will be responsible for providing development and delivery of a Case Management system that utilizes best practices in the areas of pre-admission, registration, utilization management, discharge planning, case management, and social services.

    The position also ensures that patients receive timely and appropriate care during their hospitalization, for identifying delays in treatment, and for targeting opportunities to improve or enhance resource utilization.

    Additionally, the position is accountable for ensuring timely discharge through early intervention and identification of post hospital care needs, as well as ensuring continuity of care needs are met.


    Essential Functions:
    Knowledge/Skills:Knowledge of requirements and eligibility parameters for payers, MediCal, and MedicareKnowledge of IPA'sKnowledge of Epic EMR systemKnowledge of third party payer billing and managed care requirementsKnowledge of the Joint Commision and Public Health licensing requirementsLeadership skills consistent with the mission, vision, and values of the Health SystemGeneral knowledge of illnesses, current treatments, and their physical and psychosocial sequelaeKnowledge of applicable laws and regulations, government, and insurance benefitsKnowledge of utilization review process, discharge planning process, use of best practice guidelines and pathwaysKnowledge of statistical data collection techniques and methods of analyzing and reporting statistical dataDemonstrated leadership skills, including facilitating teamwork, coaching, consensus-building and problem-solvingStrong foundation of clinical assessment skills necessary to provide care management for clients with highly complex medical, emotional, and social needs

    Improve Performance:
    Strengthens focus on excellence in a culture that measures quality and continues improvement of performance to meet the needs and expectation of patients and communityAssures that organizational and department policies and procedures are current, appropriate, and followed consistentlyAssures a safe and efficient work environment for employees, assures quality improvement processes are effectively monitoring quality of services and lead to strategies for further improvementCreates excellence in how customers are served both internally and externally with staff, works proactively to resolve complex problems in a timely mannerFollows the performance improvement process, including regular dialogue and feedback with employees about goals, responsibilities, expectations, and performanceFacilitates implementation of new technology, products, and supplies to provide safe, effective services and maximize productivityModels and encourages a spirit of service in the organization (i.e. coordination and delivery of patient care that responds to patient and family needs, physical, physiological, spiritual, and social needs; interdisciplinary QI activities, participation in committees and PI teams)Understands and helps others integrate the mission, vision, and values to the strategic goals and operations.


    Communication:
    Has been in previous leadership position and can effectively mentor counterpartsClearly communicates the strategic initiatives and direction of the Health system, the region, the area, and the ministryActs as a liaison by effectively involving Medical staff, other departments, and stakeholdersMaintains accessibility for 1:1 communication with staff and provides avenues for appropriate follow up with employeesUtilizes team building strategies to promote positive relationships for a cohesive teaOpenly discusses issues and supports difficult decisionsFiscal StewardshipAssumes responsibility and accountability for fiscal management of assigned departments across all entities in collaboration with staff and physiciansFormulates, presents, and defends annual budget (including personnel, supplies, resources, and space) based on assessments of departments resources, programs, and projected needsAnalyzes trends and identifies opportunities to improve efficiency and productivity and decrease costsImplements changes in systems, equipment, and technology to increase efficiency and productivity and to promote cost containmentCompetencyHolds self and staff accountable for excellence in performanceAssures timely assessment of employee performanceIdentifies and assures resolution of discrepancies between performance standards through coaching, feedback, and use of the progressive disciplinary processEstablishes processes to listen and respond to employees concerns, grievances, and suggestionsPlanningInitiatives strategic, operational, and programmatic plans/policies to achieve mission and area by vision by providing efficient and effective servicesEncourages ideas, suggestions, and participation of others and involves others in planning, decision-making, and assessment processesPerforms periodic follow-up to assure actual implementation of changes and their effect on the organizationIdentifies and fulfills educational and developmental needs and keeps updated on advances related to responsibilitiesRequirements:Bachelors Degree in NursingMasters Degree in Nursing - preferredCalifornia RN license

    #J-18808-Ljbffr
  • Titan Industries

    IT Project Manager

    1 week ago

    Titan Industries Fresno, United States

    If you are a digital native, AVANTGARDE Experts is the right place for you. We place exciting positions in the digital industry throughout Germany - from junior social media managers to senior digital project managers (m/f/d). Apply now for one of the many positions with our attr ...

  • Cascade Ventures

    Construction Manager

    1 week ago

    Cascade Ventures Fresno, United States

    About the Company · We develop automation and system technology for ships and industrial plants. From Bremen and Rostock, we operate worldwide and provide everything from one source: from design and software development to manufacturing and commissioning. Our alarm and monitoring ...

  • Sapphire Enterprises

    Commercial management

    1 week ago

    Sapphire Enterprises Fresno, United States

    About the Company · Our company has been in existence since 1906 as one of the leading manufacturers of components and services for the petrochemical/chemical industry worldwide. · Our constantly expanding product portfolio includes a variety of essential parts that are custom-de ...

  • GSR Brokerage Inc.

    Transportation Manager

    1 week ago

    GSR Brokerage Inc. Fresno, United States

    Employees will be given opportunity to grow and explore the transportation industry. · Job Description as follow · - Scheduling drivers to make freight deliveries or collect shipments and packages. · - Communicating with customers/carriers about freight details, delivery or picku ...

  • Timewise Food Stores

    Assistant Manager

    1 week ago

    Timewise Food Stores Fresno, United States

    **Timewise Food Stores is immediately hiring friendly and energetic individuals to join our growing team** · - ** · Competitive Pay & Benefits**: · - ** Starting pay based on experience and may vary**: · - **PTO**: · - ** 401K with Company match**: · - ** Schedules provided 2 wee ...

  • Spectrum Innovations

    Junior Project Manager

    3 weeks ago

    Spectrum Innovations Fresno, United States

    As the economic center of the Nordschwarzwald region, the city of Pforzheim is one of the most important business locations in Baden-Württemberg. With a population of around inhabitants, the city, known as the "City of Jewelry and Gold", manages and plans a wide range of projects ...

  • Oceanic Enterprises

    Junior Interface Manager

    1 week ago

    Oceanic Enterprises Fresno, United States

    As a Junior Interface Manager (m/w/d) in Fresno, you will dive into the exciting world of data migration. You will work closely with our clients to understand their individual requirements and develop specialized solutions that seamlessly connect systems like ERP with online shop ...

  • Taco Bell

    Assistant General Manager

    1 week ago

    Taco Bell Fresno, United States

    GET ALL-ACCESS TO: · + Same day pay · - Never wait for a paycheck again Work today, get paid tomorrow With DailyPay, Pacific Bells employees have access to their pay on day 1 of work. Make any day payday. Enjoy our most used features: · **PAY**: Transfer any amount of your availa ...

  • Titan Industries

    Area Manager

    1 week ago

    Titan Industries Yosemite Valley, United States

    Location: 80686 Munich / Schwanthalerhöhe-Laim | Contract Type: Full-time, temporary | Job ID: 818806 · What you'll be doing with us: · The fresh food counter is the heart of our REWE Center. With your expertise and a culture of respectful leadership, you will manage the service ...

  • BlueWave Solutions

    Businesswoman for Office Management

    1 week ago

    BlueWave Solutions Calwa, CA, United States Freelance

    **For our client in Mannheim, we are currently looking for:** · **Office Management Assistant (m/f/d)** · **Your main tasks include:** · - Planning, booking and billing of business trips · - General office tasks and office organization · - Coordination of administrative processes ...

  • ZephyrTech

    Area Manager for Power Grid Operations

    3 weeks ago

    ZephyrTech Fresno, United States

    We, the Stadtwerke Ilmenau GmbH, are a municipal company that is closely connected to the region and its citizens. We are responsible for the network area of the city of Ilmenau, the districts of Ilmenau-Roda, Manebach, Oberpörlitz, Unterpörlitz, Heyda (only electricity) and Oehr ...

  • Vibra Healthcare

    Materials Management Manager

    2 weeks ago

    Vibra Healthcare Fresno, United States

    Overview: · COME BUILD YOUR CAREER WITH VIBRA HEALTHCARE · We are seeking a Materials Management Manager to join our team · Responsibilities: · Responsible for organizing and managing the day-to-day Materials Management needs and operations for the facility. Researches purchasi ...

  • Ghirardelli Associates

    Project Manager

    3 weeks ago

    Ghirardelli Associates Fresno, United States

    Ghirardelli Associates is currently looking to hire an experienced Project Manager. This position will be based out of our Central Division. This is an opportunity to work with an experienced team of professionals · POSITION SUMMARY: · An Engineer IV - Project Manager is responsi ...

  • Bookman Consulting

    General Manager

    1 day ago

    Bookman Consulting Fresno, United States

    Our client is a growing Manufacturing and Distribution Company who's looking to hire a talented General Manager. This is an ON-SITE role at their facility located in Fresno CA. This is a fun, stable, and healthy company that has a family/team-centered culture. Here's a quick run- ...

  • Fresno First Bank

    Product Manager

    4 days ago

    Fresno First Bank Fresno, United States

    :Who We Are: · FFB, a dynamic and acclaimed single-branch bank born in the heart of Fresno, CA in 2005, is on a mission to redefine the banking experience. Our commitment to delivering top-notch banking services has propelled us to the forefront of the industry, earning us accol ...

  • Grand Fitness

    Assistant Manager

    1 day ago

    Grand Fitness Fresno, United States

    :Who Are We: · Founded in 2010, Grand Fitness Partners is a leading Planet Fitness Franchisee, owning and operating 66+ locations. We strive to achieve Planet Fitness' mission to enhance people's lives by providing a high-quality fitness experience in a welcoming, non-intimidatin ...

  • Fresno First Bank

    Product Manager

    1 week ago

    Fresno First Bank Fresno, United States

    :Who We Are: · FFB, a dynamic and acclaimed single-branch bank born in the heart of Fresno, CA in 2005, is on a mission to redefine the banking experience. Our commitment to delivering top-notch banking services has propelled us to the forefront of the industry, earning us accol ...

  • Fresno First Bank

    Product Manager

    3 weeks ago

    Fresno First Bank Fresno, United States

    :Who We Are: · FFB, a dynamic and acclaimed single-branch bank born in the heart of Fresno, CA in 2005, is on a mission to redefine the banking experience. Our commitment to delivering top-notch banking services has propelled us to the forefront of the industry, earning us accol ...

  • Gpac

    Project Manager

    2 weeks ago

    Gpac Fresno, United States Full time

    Project Manager · If you have estimating experience in construction project management, residential and commercial, and have excellent leadership and communication skills, reach out · Securing Production Work · Accurately estimate jobs to obtain work that will support yearly volu ...

  • WestCare

    Case Manager

    4 days ago

    WestCare Fresno, United States Full time

    POSITION SUMMARY: · Person in this position will be primarily responsible for the case management of a caseload of individuals with disabilities that are experiencing literal homelessness or are at imminent risk of becoming homeless. The case manager will work closely with the d ...