11215 Behavioral Health Contract Management Group: Charlotte - Utilization Management

Full time

Yes

40

This position is fully remote. Normal business hours M-F 8am-5pm.

Pay Range

$47.50 - $71.25

Essential Functions
• Develops programs which promote optimal quality of care, improvement of public health, maximize growth, and enhance revenue opportunities.
• Assures seamless connection between all components of service line delivery: financial, clinical/nursing, support operations, facility cross-connectivity and marketing activities.
• Determines efficacy of services and identifies opportunities to enhance product differentiation and improve competitive advantage through unified approach to services.
• Establishes innovative approaches to patient access and integration of care to include telemedicine and disease management and identifies new and emerging technologies and treatments that may be appropriate for service line.
• Promotes education, growth, and development of the staff.
• Assists with preparation of service line and departmental budgets and ensures that all financial and revenue cycle management components and goals are met.
• Works with Corporate Compliance/Coding Support to educate physicians on all coding changes and coding accuracy, and to ensure coding levels are appropriate.
• Reviews and makes recommendations for reduced overhead, cost savings, enhanced revenue, and efficiency improvements.
• Ensures the accuracy, completeness and proper handling of medical records in accordance with regulatory requirements and patient information requests.
Physical Requirements Work requires walking, standing, sitting, lifting, and reaching. Must be able to lift a minimum of 50 pounds’ shoulder high. Intact sense of sight and hearing. Finger dexterity to operate computer and calculator. Critical thinking and ability to concentrate and make decisions. Must be able to respond quickly in stressful situations.
 

Education, Experience and Certifications

Bachelor’s Degree required. Master’s Degree in Business or Healthcare Administration preferred. Minimum of 3 years’ management experience in a medical education/teaching program environment. Experience in managing hospital-based ambulatory services preferred. BLS HCP certification from AHA required.

Patient Population Served

Demonstrates knowledge of the principles of growth and development and demonstrates the skills and competency appropriate to the ages, culture, developmental stages, and special needs of the patient population served.
 

Protected Health Information
• Will limit access to protected health information (PHI) to the information reasonably necessary to do the job.
• Will share information only on a need to know basis for work purposes.
• Access to verbal, written and electronic PHI for this job has been determined based on job level and job responsibility within the organization. Computerized access to PHI for this job has been determined as described above and is controlled via user ID and password.

Our Commitment to You:

Advocate Health offers a comprehensive suite of Total Rewards: benefits and well-being programs, competitive compensation, generous retirement offerings, programs that invest in your career development and so much more – so you can live fully at and away from work, including:

Compensation

• Base compensation listed within the listed pay range based on factors such as qualifications, skills, relevant experience, and/or training
• Premium pay such as shift, on call, and more based on a teammate's job
• Incentive pay for select positions
• Opportunity for annual increases based on performance

Benefits and more

• Paid Time Off programs
• Health and welfare benefits such as medical, dental, vision, life, and Short- and Long-Term Disability
• Flexible Spending Accounts for eligible health care and dependent care expenses
• Family benefits such as adoption assistance and paid parental leave
• Defined contribution retirement plans with employer match and other financial wellness programs
• Educational Assistance Program