Warbird Consulting Partners

Interim Utilization Management Director

Location
Tennessee
Pos. Category
Healthcare - Consulting
Experience (Years)
7
Job ID
6191

Job Description

Warbird is seeking an Interim Utilization Management Director for an opportunity to assist a client with the development and implementation of a strong and effective infrastructure for the Utilization Management (UM) function across the organization and to manage the day to day operations.

 

Warbird engages talent and expertise across all of our practice areas and assembles experienced teams to solve a wide range of complex, pressing accounting and finance issues. Our consultants typically have 15-25 years plus of industry experience and know firsthand the daily challenges our clients encounter. We fit our consultants’ skills to the needs of our clients to ensure a successful experience for all. If you’re ready to take on the challenge, then let us help you advance your career in consulting!

 

 Objectives:

  • Provide Productivity metrics and Key Performance Indicators with a methodology to track, report and provide feedback to staff, department and the broader organization
  • Create an effective and timely UM strategy with a goal of reviewing patients at the time and entry-point of admission
  • Develop current UM policy, procedure, and process flows with an emphasis upon collaboration and integration of activities with other key members of the healthcare team
  • Assist to develop strategies for compliance with the Medicare Conditions of Participation for Utilization Review and any State requirements
  • Assist the team to design utilization review data analytics to measure department productivity, efficiency and effectiveness.
  • With the team, design a department “Playbook” to capture essential policies, processes and guides to daily practice
  • Implement daily, weekly and monthly reporting packages to include key perform matrix Participate in interdepartmental and intra-departmental performance improvement efforts
  • Develop payer contracting matrix identifying payer communication requirements related to UM communication and data requirements
  • Must be able to respond and uphold stated production requirements

Job Requirements

EDUCATION/CERTIFICATIONS/REQUIREMENTS:

  • Bachelor’s Degree in Healthcare, Business or related field is required
  • RN required
  • +7 years’ experience overall within Utilization Management/Authorization/etc., or three to five (3-5) years of experience in revenue cycle processes/integrity/case utilization
  • Excellent written, organizational, analytical, motivational and critical thinking skills
  • Knowledgeable of utilization management as it relates to RAC preparedness and third-party payers; knowledgeable of post-acute care community resources
  • Excellent verbal and written communication skills; ability to engage with all clinical and financial leaders in achieving organizational deliverables

 

Project will start with 3 months with a strong potential to extend to 6-12 months in length; weekly travel from Mon-Thursday required for each week.

 

Warbird is an Equal Employment Opportunity (EEO) employer and welcomes all qualified applicants. Applicants will receive fair and impartial consideration without regard to race, sex, color, religion, national origin, age, disability, veteran status, genetic data, religion or other legally protected status.  E-Verify - Warbird participates in the Electronic Employment Eligibility Verification Program.

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