UR Supervisor

Job ID
2018-1174
# of Openings
1
US-FL-Riverview
Posted Date
2 weeks ago(1/8/2018 6:39 PM)
Category
Clinical

Overview

Job Summary:

The UR Supervisor is responsible for case management and communicating census data to teams which in turn drives the level of care received by the clients.  The UR Supervisor will carry a case load and ensure the clients are covered at the appropriate level of care.  This position will provide day to day supervision of the utilization review department, which includes monitoring workflow, time & attendance, and training of new employees.

 

Reports To: Director of Business Services

Responsibilities

Job Duties:

  • Update UR census data with new admissions and level of care (LOC).  Send daily census data to clinical team and upload to Share Point for billing team.  Follow-up with UR team on missing authorizations and new admits.
  • Update monthly dashboard with key metrics, such as, number of clients, LOC, billed days, and uncovered days.
  • Track each client’s LOC changes on a data sheet and submit to Facility CEO monthly.
  • Monthly, create a random list of charts. Distribute to UR team in order to complete a quality assessment. 
  • Lead the UR meetings when Facility CEO is unavailable
  • Pre-certify insurance clients by completing reviews as needed with insurance companies  to extend the stay of client in treatment; work with the clinical and client care team to communicate insurance case managers request for specific treatment, follow ups, and individualized care; communicate authorizations to clinical team; and prepare for weekly meetings to discuss appropriate discharge dates based on authorizations
  • Responsible for verifying and approving UR Department time records in the time & attendance system.  This includes entering time edits submitted by the employees, approving PTO, and approving the timecard at the end of each pay period.
  • Oversees the workflow of the UR department.
  • Responsible and accountable for managing direct reports
  • Preparation and presentation of performance evaluations
  • Provides objective feedback to employees
  • Makes appropriate compensation recommendations, if applicable
  • Provides appropriate training  for department and hold staff accountable for attending required training
  • Holds interviews for vacant positions and makes appropriately selects candidates to fill open positions
  • Responsible for recommending and ensuring regulatory staffing patterns & managing annual budget.
  • Monitors adherence to company and department policies, procedures and practices
  • Creates and supports a positive, professional, team-oriented, harassment free work environment by understanding and complying with the company’s policies

Qualifications

Job Requirements:

  • High School Diploma required, Bachelor's Degree preferred.
  • Two year’s medical billing experience at least; prefer Bachelor degree in related field or Nursing field and or Masters Degree in Social Work.
  • Ability to read and interpret written information; write clearly and informatively; edits work for spelling and grammar. Ability to speak clearly and persuasively in positive or negative situations; listens and gets clarification; responds well to questions; demonstrates group presentation skills; and participates in meetings.
  • Working knowledge of Microsoft Word, Excel, and Outlook.
  • If in personal recovery, a minimum of 2 years clean and sober.

AAC is committed to principles of equal opportunities for all employees.  The Company will provide reasonable accommodations that are necessary to comply with State and Federal disability discrimination laws.

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