Utilization Manager RN
Company: Residential Healthcare Group
Location: Downers Grove
Posted on: October 9, 2021
Utilization Manager RN
Downers Grove, IL, USA
Working Hours Per Week
ESSENTIAL DUTIES AND RESPONSIBILITIES include the
following. Other duties may be assigned as necessary.
- Provide supervision and direction for field staff and act as
liaison between field and office staff.
- Monitor clinicians via HCHB reports
- Update Clinical Record on an ongoing basis as relates to
communications, orders, re-hospitalizations, conflicts, etc.
- Evaluate and address customer concerns, including documentation
- Communicate with sales personnel regarding customer issues that
arise and may affect referral source relationships.
- Responsible for communication with clinicians and physicians
when adult protective services referral required.
- Evaluate client episode to determine appropriateness of
discharges versus recertification and initiation of orders as
- Review and manage visit time exception requests.
- Review staff schedules to assure productivity, communicating
with PSC of staff availability, as well as providing Clinical
Manager with projected productivity for staff once/week. Obtains
physician orders for field staff from physicians, laboratory
results and resumption of care orders as needed.
- Responsible for direct management of the POD’s Clinical
Field Staff, assigning tasks and objectives, and establishing clear
measurables for monitoring results versus objectives.
- Responsible for the development and engagement of POD’s
Clinical Field Staff by fostering a motivating work environment
that recognizes and rewards strong performance.
- Review and Approve Orders, Evaluation Documentation and
frequency of visits.
- Reviews potential LUPA cases with ACD
- Participates in staff meeting and in-services.
- Distributes monthly staff meeting information to staff not
- Case conference with assigned field staff as required.
- Perform annual performance evaluations on field staff.
- Works with clinicians in developing the patient frequency of
visits that are clinically appropriate.
- Assists agency personnel in care coordination of patient/client
services. Serves as a liaison between the organization, referral
sources, and patient/clients.
- Assists in education of staff regarding hospitalizations.
- Proficient in HCHB and Outlook.
- Maintains Medicare guidelines regarding consents, ABN,
non-provider coverage forms.
- Participates in ongoing education.
All other duties as assigned.
NOTICE: Successful completion of a drug screen prior to
employment is part of our background process, which includes
medical and recreational marijuana.
By supplying your phone number, you agree to receive
communication via phone or text.
Residential Home Health and Residential Hospice is an Equal
Keywords: Residential Healthcare Group, Downers Grove , Utilization Manager RN, Other , Downers Grove, Illinois
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