Unit Manager Clinical Operations (Utilization Management)
This position is responsible for supervising clinical staff involved in a variety of clinical operations such as Utilization Management, Case Management and/or Disease Management. Responsible for hiring, training, performance reviews, pay administration, change management and ensuring staff meet/exceeds goals and initiatives. Implement processes, procedures and initiatives and monitor results, ensure delivery of effective customer service, ensure department is meeting account contracts, and work across the organization in delivery of services to the customer.
•Registered Nurse (RN), with current, unrestricted license to practice in state of IL.
•2 years clinical experience with direct clinical care to the consumer.
•2 years utilization review/ managed care experience.
•Knowledge of managed care program policies and procedures.
•Knowledge of managed care and insurance industry.
•Verbal, written, and interpersonal communication skills.
•PC proficiency to include Word, Excel, PowerPoint.
•Analytical skills and sound clinical judgment.
•Case Management Certification (URAC accredited certification) or obtain URAC accredited case management certification within three year of employment if overseeing case management operations.
PREFERRED JOB REQUIREMENTS:
•Prior experience with IL Medicaid Programs.
•Utilization Management experience.
HCSC is committed to diversity in the workplace and to providing equal opportunity and affirmative action to employees and applicants. We are an Equal Opportunity Employment / Affirmative Action employer dedicated to workforce diversity and a drug-free and smoke-free workplace. Drug screening and background investigation are required, as allowed by law. All qualified applicants will receive consideration for employment without regard to race, color, religion, sex, sexual orientation, gender identity, national origin, disability, or protected veteran status.
Requirements: Expertise Nursing Job Type Full-Time Regular Location IL - Downers Grove
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