The Utilization Management Team Lead provides effective leadership and delegation by coordination and integration of services within the department to assure the provision of quality of care. This position provides supervision and support to the Utilization Management staff. Provides administrative support for the department and assists leadership with identifying and meeting productivity and staffing needs.

• Assigns and coordinates daily assignments. Assists with assignments as needed in event of absent team members.
• Consistently strives to understand, anticipate, and meet the needs, expectations, and satisfaction of patients, visitors, payers, and other Revenue Cycle team members.
• Seeks feedback from same to help improve performance.
• Participates in data collection for use in improvement of Utilization Management initiatives.
• Identifies and assists in the development of long and short term projects to meet patient, staff, unit, and organizational needs as assigned.
• Assists in scheduling staff based on staffing patterns of the department.
• Monitors productivity of staff, use of time and delegates personnel according to capabilities to meet the needs of the department.
• Monitors clinical documentation in the medical records to ensure completeness and accuracy and compliance with system standards.
• Utilize MCG guidelines to ensure correct patient admission status, medical necessity conformance, and appropriateness of continued stay.
• Develops and maintains communication with the physicians and the multi-disciplinary team regarding patient admission status and needs.
• Collaborates with department leadership in the hiring and termination of staff, progressive discipline, coaching and development, and staff evaluations.
• Ensures a safe, clean, environment for team members and visitors.
• Functions as a resource to Utilization Management staff.
• Observes and coaches staff in performance of duties and interpersonal interactions. Evaluates educational needs of staff and accesses resources when needed.
• Supports leadership in ensuring compliance with federal, state, and other applicable requirements. Participates in the implementation of program philosophy, objectives, standards of care, and procedures on consultation with leadership.
• May be asked to assist with other duties at the discretion of department leadership.

Preferences:
2 Years Utilization Management Experience
2 Years MCG utilization