Utilization Mgmt Pgm Mgr - University of Rochester

Responsibilities **Utilization Management Program Manager Job Description:** The Manager role works under the direction of and in collaboration with the Associate Director of Utilization Management in the performance of all assigned functions and duties. The Manager role is also responsible for team member education, training, performance evaluation, and scheduling. He/she also is responsible for team member compliance with regulatory requirements and relevant policies and protocols. A major responsibility of each Manager is to develop and accomplish targeted operational objectives. The Utilization Management Program Manager has oversight for one of the below product lines depending on their area of interest and expertise. + Level of care and determination of medical necessity. + Management of retrospective denials for SMH and affiliates to support appropriate revenue cycle billing. + Coordination of clinical documentation improvement practices consistent with corporate compliance guidelines and appropriate financial reimbursement based on the acuity of the patient population. **Qualification** : RN Licensure, B.S.N. required, Masters, preferred, 3-5 years UM experience preferred and 1-2 years supervisory experience or relevant leadership experience. Two to three years of Clinical Documentation Improvement (CDI) experience is preferred when assigned to the CDI team. The University of Rochester is committed to fostering, cultivating, and preserving a culture of equity, diversity, and inclusion to advance the University’s mission to Learn, Discover, Heal, Create – and Make the World Ever Better. In support of our values and those of our society, the University is committed to not discriminating on the basis of age, color, disability, ethnicity, gender identity or expression, genetic information, marital status, military/veteran status, national origin, race, religion/creed, sex, sexual orientation, citizenship status, or any other status protected by law. This commitment extends to the administration of our policies, admissions, employment, access, and recruitment of candidates from underrepresented populations, veterans, and persons with disabilities consistent with these values and government contractor Affirmative Action obligations. **How To Apply** All applicants must apply online. _EOE Minorities/Females/Protected Veterans/Disabled_ **Pay Range** Pay Range: $83,720 - $117,208 Annually _The referenced pay range represents the minimum and maximum compensation for this job. Individual annual salaries/hourly rates will be set within the job’s compensation range, and will be determined by considering factors including, but not limited to, market data, education, experience, qualifications, expertise of the individual, and internal equity considerations._ **Location:** Strong Memorial Hospital **Full/Part Time:** Full-Time **Opening:** Full Time 40 hours Grade 044 Utilization Management **Schedule:** 8 AM-4:30 PM; WKNDS AS NEEDED