“The best place to give care. The best place to get care.” That is the Saint Luke’s vision and, whether in a hospital, clinic, practice or office, our nearly 11,000 employees strive toward that vision every day. Saint Luke’s employees are proud of our rich history and heritage, and that we remain the only faith-based, nonprofit, locally owned health system in Kansas City. Joining Saint Luke’s means joining a team of exceptional professionals who always strive for excellence in patient care.
The Manager of Utilization Review is responsible for overall policy and operational accountability for utilization review to meet system strategic goals and directions. This position oversees utilization for all patient encounters. This includes management of the department budget, hiring and performance management. The manager is responsible for supporting the educational and training needs of staff with day-to-day operations and supervision, as well as assisting the System Director with strategic planning and implementation of newly revised processes. Requires an active participation in process improvement, JCAHO preparedness, payor collaboration and other hospital committees. The Manager of Utilization Review works closely with each entity and system leadership.
Experience: Managerial experience in utilization review in hospital setting. Experience with implementing and overseeing a utilization review program. Extensive knowledge of reimbursement mechanisms, denial prevention and clinical utilization management. Working knowledge of state and federal government regulations such as RAC/MAC, 2 Midnight Rule, readmissions, efficiency of care across the continuum and accountable care organization models. Requirements include BSN in Nursing, Registered Nurse Missouri and Kansas License and 3-5 years experience in Utilization Review.
Bachelor's Degree (Required)
Registered Nurse (KS) - National Council of State Boards of Nursing (NURSYS), Registered Nurse (MO) - National Council of State Boards of Nursing (NURSYS)
Join the Kansas City region's premiere provider of health services. Equal Opportunity Employer. We hire only non-tobacco users.
Internal Number: 0005028
About Saint Luke's Health System
Looking for a new career opportunity? You’ve come to the right place. We've been honored as one of the best places to work in Kansas City and one of the most wired health networks in the United States. And we know we owe it all to our employees. Click on the links below to learn more about the opportunities at Saint Luke’s 10 hospitals and affiliated services.