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Manager, Clinical in Scarborough, ME at KEPRO

Date Posted: 1/5/2018

Job Snapshot

Job Description

KEPRO

JOB DESCRIPTION

JOB TITLE:              Manager, RN Clinical  

REPORTS TO:       Clinical Director

DEPARTMENT:       Clinical

FLSA STATUS:       Exempt

 Summary Description

Serve as the lead to oversee Assessment and Utilization Management functions for the project. Coordinates with the Client on decisions and issues, and communicates with providers and facilities regarding assessment decisions and other clinical matters. Develops and leads staff in the activities required to perform clinical services in order to facilitate and support quality, cost effect outcomes and minimize fragmentation of health care delivery.

 Accountabilities

  • Oversee, coordinate, and monitor all team activities.
  • Ensure adequate staffing and contractual service levels are adhered to by implementing and monitoring clinical staff productivity and performance indicators. Maintains effective team member relations.
  • Leads team members in improving utilization management skills, creativity, and problem solving.
  • Work with management team to develop and enhance the operational structure including skill set requirements, gap analysis, and training using workforce planning.
  • Manages and completes assigned work plan objectives and projects on a timely basis.
  • Provide advice and assistance to leaders in the planning, implementation, and evaluation of modifications to existing operations, systems, and procedures. Collaborate with leadership in the development of new and enhanced products and services.
  • Represents the clinical department by participating on committees, task forces, work groups, and multidisciplinary teams. Maintains professional relationships with provider community and external customers and identifies opportunities for improvement.
  • Participates in the development of policies and oversees clinical staff activities to ensure compliance with regulatory and accrediting standards.
  • Provides reports of compliance activities.

The list of accountabilities is not intended to be all-inclusive and may be expanded to include other education- and experience-related duties that management may deem necessary from time to time.

Qualifications

  • Education (general level if required) or specific courses
  • Bachelor’s degree and active.
  • Non-restricted, clear RN license required.

Skills, Knowledge

  • Demonstrated proficiency in MS Office applications.
  • Ability to maintain a positive attitude and contribute both as an individual and a team member to achieve the goals of the department.
  • Ability to professionally respond to change and handle multiple and changing priorities with sometimes conflicting deadlines.

Experience

  • 5+ years of clinical experience
  • Minimum of 3 years’ experience in UM/UR and Appeals preferred.
  • Experience with State Medicaid programs preferred.
  • Minimum 3 years staff/workload management experience required.

Mental and Physical Requirements

The physical demands described here are representative of those that must be met by an employee to successfully perform the essential functions of this job.  Reasonable accommodations will be made as required by law in an attempt to enable an individual with a disability to perform the essential functions of this job. While performing the duties of this job, the employee is regularly required to sit for prolonged periods of time; key and/or control objects; interact extensively with internal and external customers; occasionally lift and/or move objects weighing up to 10 pounds; and occasionally travel within the state.

EOE AA M/F/Vet/Disability



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