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Indiana University Health

Manager-Clinical Population Health Utilization

IU Health Plans
Date Posted
17 June, 2021
Schedule & Shift
Full Time
Day
Requisition Number
308098
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Manager-Clinical Population Health Utilization

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Job Description

Overview

Provides direction and leadership to assigned personnel and ensures that all management functions are performed accurately and efficiently. Manages ongoing analysis, development, and implementation of methods and systems to provide overall effectiveness of Utilization Management processes. Assists to develop services, policies, and procedures. Promotes patient advocacy and quality patient care with unsurpassed clinical and cost outcomes. Guides and supports department staff in the delivery of Utilization Management services and coordination of interventions to meet the acute and post-acute needs of patients/families. Monitors unique patients and outliers through daily interaction with Utilization management staff; collaborates with other departments to establish processes to address delays and barriers. Guides staff in the assessment, planning, implementation, monitoring, and evaluation of Utilization management interventions. Monitors outcomes related to the provision of and availability of Utilization management services. Identifies barriers to movement of patients through the continuum, and recommends strategies. Elevates cases to a high level for intervention or resolution as required.


 Bachelor's Degree in Nursing Required.
• Master's preferred.
• Requires a minimum of one year of leadership/management experience.
• Requires knowledge of managed care and payer issues, as well as utilization management principles and standard practices.
•Active/unrestricted Nursing/Registered Nurse (RN) License is required.
• Minimum of 3-5 years of healthcare experience in a utilization role.
• 

 

We are an equal opportunity employer and value diversity and inclusion at IU Health. IU Health does not discriminate on the basis of race, color, religion, sex, sexual orientation, age, disability, genetic information, veteran status, national origin, gender identity and/or expression, marital status or any other characteristic protected by federal, state or local law. We will ensure that individuals with disabilities are provided reasonable accommodation to participate in the job application or interview process, to perform essential job functions, and to receive other benefits and privileges of employment. Please contact us to request accommodation.

Qualifications for the Manager-Clinical Population Health Utilization Role

Overview

Provides direction and leadership to assigned personnel and ensures that all management functions are performed accurately and efficiently. Manages ongoing analysis, development, and implementation of methods and systems to provide overall effectiveness of Utilization Management processes. Assists to develop services, policies, and procedures. Promotes patient advocacy and quality patient care with unsurpassed clinical and cost outcomes. Guides and supports department staff in the delivery of Utilization Management services and coordination of interventions to meet the acute and post-acute needs of patients/families. Monitors unique patients and outliers through daily interaction with Utilization management staff; collaborates with other departments to establish processes to address delays and barriers. Guides staff in the assessment, planning, implementation, monitoring, and evaluation of Utilization management interventions. Monitors outcomes related to the provision of and availability of Utilization management services. Identifies barriers to movement of patients through the continuum, and recommends strategies. Elevates cases to a high level for intervention or resolution as required.


  • qualifications__list
     Bachelor's Degree in Nursing Required.
  •  Master's preferred.
  •  Requires a minimum of one year of leadership/management experience.
  •  Requires knowledge of managed care and payer issues, as well as utilization management principles and standard practices.
  • Active/unrestricted Nursing/Registered Nurse (RN) License is required.
  •  Minimum of 3-5 years of healthcare experience in a utilization role.
  •  

Job Page Content image

Indiana University Health is Indiana’s most comprehensive health system, with 16 hospitals and more than 34,000 team members serving Hoosiers across the state. Our partnership with the Indiana University School of Medicine gives our team members access to the very latest science and the very best training, advancing care for all. We’re looking for team members who share the things that matter most to us. People who are inspired by challenging and meaningful work for the good of every patient. People who are compassionate and serve with a purpose. People who aspire to excellence every day. People who are always ready to apply themselves.

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