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Director - Utilization Review - Miramar Florida
Company: Memorial Healthcare System Location: Miramar, Florida
Posted On: 10/19/2024
Location:Miramar, FloridaAt Memorial, we are dedicated to improving the health, well-being and, most of all, quality of life for the people entrusted to our care. An unwavering commitment to our service vision is what makes the difference. It is the foundation of The Memorial Experience.Summary:Directs the department's activities and resources to ensure alignment with the mission, values, and objectives of the department and organization.Responsibilities:Prepares and evaluates departmental budgets, and ensures that the department operates in compliance with allocated funding. Coordinates and directs internal/external audits.Plans and monitors staffing activities, including hiring, orienting, evaluating, disciplinary actions, and continuing education initiatives.Manages and evaluates department operations, including information technologies, service level determination and complaint management, to achieve performance and quality control objectives.Develops and implements departmental goals, plans, and standards consistent with the clinical, administrative, legal and ethical requirements of the organization.Works collaboratively with other disciplines, physician liaison, and facility Directors of Clinical Effectiveness to ensure that utilization review is performed timely, accurately and in compliance with appropriate regulatory bodies.Competencies:ACCOUNTABILITY, ANALYSIS AND DECISION MAKING, CUSTOMER SERVICE, EFFECTIVE COMMUNICATION, MANAGING BUDGETS - MANAGEMENT, MANAGING PEOPLE, RESPONDING TO CHANGE, STANDARDS OF BEHAVIOREducation and Certification Requirements:Accredited Program: Nursing (Required)Registered Nurse License (RN LICENSE) - State of Florida (FL)Additional Job Information:Complexity of Work: Requires critical thinking skills, decisive judgment and the ability to work with minimal supervision. Must be able to work in a stressful environment and take appropriate action. Excellent interpersonal skills needed.Required Work Experience: 5 years leadership experience and 2 years experience in utilization case management.Working Conditions and Physical Requirements: |
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