Director - Utilization Review/Case Management

Cedar Hill Regional Medical Center - Opening in 2025!

When open in early 2025, Cedar Hill Regional Medical Center GW Health will be the first new full-service hospital in Washington, DC in more than 20 years, integrating clinical care with existing community providers, Federally Qualified Health Centers (FQHC's), The George Washington University Hospital, and our Urgent Care Center in Ward 8. This integrated delivery system will establish a robust network of care for all District residents, but more importantly, it will ensure residents of Wards 7 and 8 have access to high quality care in their community.

This full-service hospital will include 136 beds (with the ability to expand to 184 beds), a verified trauma center, adult and pediatric emergency departments, maternal health and newborn delivery, an ambulatory pavilion for clinic visits and other outpatient services, a 500-car garage and a helipad for emergency transport.

We are seeking a Director of Utilization Review /Case Management

Our ideal candidate will have 24-hour, 7 days a week responsibility for the operational management and strategic planning of multiple services and/or departments.

Managerial Responsibilities

• In collaboration with the Chief Financial Officer, responsible for the development of both long- and short-range goals for the department and services that are consistent with goals and objectives of the hospital; ensures implementation of plans and the meeting of goals; and measures compliances in collaboration with hospital administration.
• Establishes course of action for self and others to accomplish a specific goal in concert with organizational objectives; plans appropriate follow-up activities unless otherwise communicated to supervisor with only rare exceptions. Monitors results.
• Educates and monitors staff regarding their own and the organizations responsibilities for regulatory compliance. Proactively identifies deficiencies and takes appropriate corrective action with only rare exception.
• Provides employees with clarity about expectations and clear feedback about performance, deals with performance problems in an appropriate and timely way with only rare exception.
• Responsible for implementation of, and employee compliance with, hospital policies and procedures and regulatory standards.
• Responsible for employee matters, which include staff selection, management, and development ensuring adequate numbers of qualified employees to provide safe, effective, and efficient services in accordance with established standards and productivity levels.
• Applies knowledge of growth and development over the life span and assesses and ensures competency and active license status (if appropriate) of the clinical staff.

Utilization Management

• Plans, develops, coordinates and maintains manual and automated information, storage and retrieval systems relating to management of medical cases, case coordination, denial management, clinical pathways, utilization management, case mix and their integration into the health setting.
• Administrates and oversees the Case Management Program to procure and coordinate a seamless delivery of healthcare services, based on the patient s /client/families wishes and needs, that result in high-quality, cost-effective outcomes at any point through the continuum of care/service.
• Prepares reports utilization statically methodologies to display findings for analysis by the medical staff/and or professional staff.

As a Cedar Hill Regional Medical Center employee, you will be part of an exceptional team with the following benefit offerings:

• Challenging and rewarding work environment
• Competitive Compensation & Generous Paid Time Off
• Excellent Medical, Dental, Vision and Prescription Drug Plans
• 401(K) with company match and discounted stock plan
• SoFi Student Loan Refinancing Program
• Career development opportunities within UHS and its 300+ Subsidiaries!

More information is available on our Benefits Guest Website: benefits.uhsguest.com.

About Universal Health Services

One of the nation's largest and most respected providers of hospital and healthcare services, Universal Health Services, Inc. (UHS) has built an impressive record of achievement and performance. Growing steadily since its inception into an esteemed Fortune 500 corporation, annual revenues were $14.3 billion in 2023. During the year, UHS was again recognized as one of the World's Most Admired Companies by Fortune; and listed in Forbes ranking of America's Largest Public Companies.

Headquarters in King of Prussia, PA, UHS has approximately 96,700 employees and continues to grow through its subsidiaries. Operating acute care hospitals, behavioral health facilities, outpatient facilities and ambulatory care access points, an insurance offering, a physician network and various related services located all over the U.S. States, Washington, D.C., Puerto Rico and the United Kingdom. www.uhs.com.

To learn more visit https://cedarhillregional.com or https://jobs.uhsinc.com/cedar-hill-regional-medical-center.

Requirements:

• BSN required
• MS in nursing or Master s degree in related field preferred
• Current RN license in the District of Columbia required
• Certification in specialty preferred
• Minimum of ten years of experience in utilization and case management in an acute care setting including 5 years at a supervisory level
• Previous experience in case management, discharge planning or utilization management
• Demonstration through prior employment history and course work
• Consistent progressive leadership role responsibilities, fiduciary accountability and evidence of consistently exceeding departmental and/or business unit performance and financial objectives

Skills:

• Effective communication skills, both verbal and written
• Effective interpersonal skills
• Ability to maintain confidentiality
• Ability to adapt to multiple and changing priorities

EEO Statement

All UHS subsidiaries are committed to providing an environment of mutual respect where equal employment opportunities are available to all applicants and teammates. UHS subsidiaries are equal opportunity employers and as such, openly support and fully commit to recruitment, selection, placement, promotion and compensation of individuals without regard to race, color, religion, age, sex (including pregnancy, gender identity, and sexual orientation), genetic information, national origin, disability status, protected veteran status or any other characteristic protected by federal, state or local laws.

We believe that diversity and inclusion among our teammates is critical to our success.

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At UHS and all our subsidiaries, our Human Resources departments and recruiters are here to help prospective candidates by matching skill set and experience with the best possible career path at UHS and our subsidiaries. During the recruitment process, no recruiter or employee will request financial or personal information (e.g., Social Security Number, credit card or bank information, etc.) from you via email. Our recruiters will not email you from a public webmail client like Hotmail, Gmail, Yahoo Mail, etc.

If you suspect a fraudulent job posting or job-related email mentioning UHS or its subsidiaries, we encourage you to report such concerns to appropriate law enforcement. We encourage you to refer to legitimate UHS and UHS subsidiary career websites to verify job opportunities and not rely on unsolicited calls from recruiters.

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