Clinical Manager Utilization Care Management 61000
Overview
SelectHealth seeks a Clinical Manager to lead Utilization Review and Care Management teams delivering high quality cost effective services. This role drives program innovation and fosters professional development while meeting financial and clinical objectives. The ideal candidate excels in leadership communication and regulatory compliance.
What You'll Do10
- 1Lead supervise and mentor RN or Behavioral Health Care Managers and Utilization Review clinicians ensuring clinical excellence and compliance.
- 2Oversee daily operations staffing resources and workflow optimization.
- 3Manage departmental budgets and performance evaluations achieving financial stewardship.
- 4Develop implement and monitor program structures outcome standards for Utilization Review and Care Management.
- 5Facilitate interdisciplinary collaboration among members families providers and payers.
- 6Ensure compliance with NCQA CMS and Joint Commission regulations and patient safety initiatives.
- 7Champion continuous improvement address gaps and monitor internal processes and metrics.
- 8Coordinate safe transitions of care including discharge planning and repatriation to participating providers.
- 9Create and present reports on program performance outcome measures and return on investment.
- 10Support staff development mentorship and community outreach activities.
Requirements6
- 1Bachelor’s degree in Nursing or Master’s degree in Clinical Social Work current licensure with compact privileges transferable within 60 days.
- 2Leadership or supervisory experience in clinical or managed care settings.
- 3Two years of clinical experience and one year in care management or utilization review.
- 4Strong written and verbal communication skills intermediate computer skills and ability to troubleshoot independently.
- 5Completion of required leadership training within one year of acceptance.
- 6Master’s degree preferred in a clinical education or business specialty specialty certification in care management or utilization review experience in program development and oversight project management organizational skills physical ability to read assess information and manual dexterity for computer use and equipment handling may require sitting standing driving ability to read signs and signals.
Salary Insight
$92 - $144k per year
Location
Required Skills
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