RN Manager of Utilization Review
Company: St. Rose Hospital
Posted on: May 3, 2022
JOB - SUMMARY: -The Manager of Case Management and Social
Services is responsible for the development of staff and systems to
effectively operate a comprehensive Case Management and Social
Service Program. Provides leadership and supervision to case
managers, social workers, and case management coordinators.
Provides for service organization and operation, program
development, and administrative oversight. Assures the efficient
delivery and quality of services provided is consistent with
professional standards of Case Management, Social Services, and
Duties and Responsibilities
Assists in clinical reviews utilizing criteria approved by the
Utilization Review Committee. Determines priorities in which
patients need to be reviewed.
Applies appropriate clinical judgment in the review process to
ensure that information in the medical records meets the criteria
for the intensity of care level of service for continued hospital
stay and/or discharge.
Develops and implements department policies, procedures, and
Interviews, selects, hires, evaluates, and provides orientation and
training of new employees.
Develops/Participates in Organization Improvement Plan activities
in accordance with overall hospital policy.
Facilitates effective time management among all Case
Management/Social Services staff; identifies and effectuates
systems for the provision of services that are most efficient.
Encourages continuing education at all levels and the
sharing/exchange of skills and knowledge among all Case
Management/Social Services rehabilitation staff to foster a goal of
Evaluates staff development and educational needs and identifies
appropriate resources as necessary.
Reviews the performance and skills of professional and support
staff annually and ensures appropriate disciplinary action within
hospital policies and procedures.
Identifies needed resources and makes those needs known to the
organization. Plans and participates in the clinical supervision of
students and volunteers as appropriate.
Participates in planning social work components in selected
Prepares each fiscal year's Operating, Capital Expense Budget, and
Provides Administration with monthly variance reports.
Assists in conducting orientation programs for new nursing hospital
Plans, organizes, and delivers in-service educational program Case
Management/Social Services staff at least four times a year.
Provides consultation to physicians and hospital staff regarding
psychosocial issues and discharge problems.
Develops and recommends programs as needed and implements the same
to improve quality and cost-effectiveness.
Keeps abreast of current trends and developments as related to Case
Management/Social Services, discharge plans, and home health.
Suggests and introduces new methods and techniques.
Participates in professional activities in order to continue their
own professional development and contribute to that of the
Demonstrates competence in the skills within the scope of practice
including age and condition appropriate considerations.
Integrates with various departments in order to enhance patient
Performs other duties as assigned or required.
1. Current CA RN license required.
2. BSN required.
4. Current Basic Life Insurance (BLS) required.
To protect the health of our patients and our health care workers,
and to preserve the safety of the St. Rose Hospital healthcare
environment, we require all health system employees, trainees,
volunteers, and others who regularly work within the health system
to be fully vaccinated against COVID-19, including booster.
Keywords: St. Rose Hospital, Hayward , RN Manager of Utilization Review, Executive , Hayward, California
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