Supervisor of UM
<p style="text-align:center;"><span style="text-decoration:underline;"><strong><span style="font-family:'times new roman', times, serif;font-size:12pt;">Supervisor of Utilization Management - Concurrent Review</span></strong></span></p> <p style="text-align:center;"><span style="font-family:'times new roman', times, serif;font-size:12pt;">VillageCareMAX</span></p> <p style="text-align:center;"><span style="font-family:'times new roman', times, serif;font-size:12pt;"><span style="font-family:'Times New Roman', serif;font-size:12pt;">112 Charles Street, New York, NY 10014</span></span></p> <p style="text-align:center;"><span style="font-family:'times new roman', times, serif;font-size:12pt;"><span style="font-family:'Times New Roman', serif;font-size:12pt;"><strong>**MUST LIVE IN NJ/NY/CT**</strong></span></span></p> <br> <p><span style="font-family:'times new roman', times, serif;font-size:12pt;">VillageCare is looking for a motivated RN for our Supervisor of Utilization Management - Concurrent Review opening. This role <span style="line-height:107%;color:#000000;">is responsible </span>for the oversight of concurrent review and discharge planning process for members with inpatient and skilled nursing facility stays. Training, mentoring, and monitoring work process and output will be essential to this role. </span></p> <p><span style="font-family:'times new roman', times, serif;font-size:12pt;">Some daily responsibilities will include:</span></p> <ul> <li><span style="font-family:'times new roman', times, serif;font-size:12pt;">Supervise staff to ensure concurrent and post reviews for inpatient acute care, skilled and long-term care facilities are completed in a timely manner.</span></li> <li><span style="font-family:'times new roman', times, serif;font-size:12pt;">Reconcile inpatient and SNF census daily, addressing any discrepancies.</span></li> <li><span style="font-family:'times new roman', times, serif;font-size:12pt;">Ensure daily assignments are completed at the close of the day. </span></li> <li><span style="font-family:'times new roman', times, serif;font-size:12pt;">Facilitate inpatient and discharge planning rounds on a weekly basis.</span></li> <li><span style="font-family:'times new roman', times, serif;font-size:12pt;">Ensure that Interqual Guidelines or other criteria adopted by the VCMAX are appropriately applied to inpatient reviews.</span></li> <li><span style="font-family:'times new roman', times, serif;font-size:12pt;">Review complex cases and authorizations of services with Medical Director.</span></li> <li><span style="font-family:'times new roman', times, serif;font-size:12pt;">In collaboration with the medical management team develop and implement projects, systems, programs, policies, and procedures.</span></li> <li><span style="font-family:'times new roman', times, serif;font-size:12pt;">Assist UM and Care Management Team to prepare for audits and other regulatory activities</span></li> <li><span style="font-family:'times new roman', times, serif;font-size:12pt;">Conducts orientation and training related to Concurrent Review Unit functions for all VCMAX staff, including the development and maintenance of training materials, in conjunction with the Training and Development team.</span></li> </ul> <br> <p><strong><span style="font-family:'times new roman', times, serif;font-size:12pt;">We would like to speak to those who have a current and unrestricted New York State RN license. Bachelor's degree in Nursing required, advanced degree preferred. 2 years of utilization review experience at a Managed Care Organization or Health Plan required. Supervisory experience required. <span style="font-size:12pt;line-height:107%;font-family:'times new roman', times, serif;">Knowledge of Medicaid and/or Medicare regulations along with ability to apply Interqual Care Guidelines will be essential to this role. URAC/CCM certifications preferred.</span></span></strong></p> <br> <p><span style="font-family:'times new roman', times, serif;font-size:12pt;">There are many benefits to working for VillageCare. If you are someone who likes being part of a team, enjoys a highly competitive benefits package from world leading carriers and competitive compensation, than we would love to speak with you! </span></p> <ul> <li><span style="font-family:'times new roman', times, serif;font-size:12pt;">PTO package, </span><span style="font-family:'times new roman', times, serif;font-size:12pt;">10 Paid Holidays, </span><span style="font-family:'times new roman', times, serif;font-size:12pt;">Personal and Sick time, </span><span style="font-family:'times new roman', times, serif;font-size:12pt;">Medical/Dental/Vision, </span><span style="font-family:'times new roman', times, serif;font-size:12pt;">HRA/FSA, </span><span style="font-family:'times new roman', times, serif;font-size:12pt;">Education Reimbursement, </span><span style="font-family:'times new roman', times, serif;font-size:12pt;">Retirement Savings 403(b), </span><span style="font-family:'times new roman', times, serif;font-size:12pt;">Life & Disability, </span><span style="font-family:'times new roman', times, serif;font-size:12pt;">Commuter Benefits, </span><span style="font-family:'times new roman', times, serif;font-size:12pt;">Paid Family Leave, </span><span style="font-family:'times new roman', times, serif;font-size:12pt;">Additional Employee Discounts</span></li> </ul> <br> <p><span style="font-family:'times new roman', times, serif;font-size:12pt;">VillageCare offers a wide range of at-home and community-based services, as well as managed long-term care options that seek to match each individual's needs to help them attain and maintain the greatest level of independent living possible. We are committed to superior outcomes in quality health care.</span></p>