Top 64 Quality compliance manager Jobs in Paris, Il

Utilization Review Manager - SUD
Anabranch Recovery Center —Terre Haute, IN
- Full-time
- CPR Certification
- Nursing
- RN License
Quick Apply
14d
Quality Manager
STERLING —Terre Haute, IN
- Microsoft Excel
- Management
- Construction site
Quick Apply
14d
Quality Assurance Manager
ENTEK —Terre Haute, IN
- $120,000 - $135,000 a year
- Full-time
- Management
- 5 years
- Engineering
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Quality Compliance Manager
Maker's Pride —Terre Haute, IN
- Full-time
- Writing skills
- English
- Mid-level
Quick Apply
Quality Control Manager
William Charles Construction —West Terre Haute, IN
- Full-time
- Background check
- Construction site
- 5 years
- AD&D insurance
- Employee stock purchase plan
7d
Quality Control Manager
CEI Services —West Terre Haute, IN
- Full-time
- Background check
- Construction site
- 5 years
- AD&D insurance
- Employee stock purchase plan
7d
Quality Control Manager
MasTec Inc —West Terre Haute, IN
- Full-time
- Background check
- Construction site
- 5 years
- AD&D insurance
- Employee stock purchase plan
7d
SURGERY CENTER MANAGER
Horizon Health —Paris, IL
- $69,903 - $111,844 a year
- Full-time
- Nursing
- Surgery
- RN License
- 403(b) matching
- Health savings account
Quick Apply
7d
MANAGER of NON-INVASIVE CARDIOLOGY
Union Health —Terre Haute, IN
- Email
- Hospital
- 5 years
- BLS Certification
- 403(b) matching
- Tuition reimbursement
Dispensary General Manager
High Profile —Martinsville, IL
- Weekends as needed
- Background check
- Merchandising
- 21 years or older
- Paid holidays
- Disability insurance
Quick Apply
22h
Plant Manager
Amrize —Charleston, IL
- $145,000 - $175,000 a year
- Full-time
- Residential
- 3 years
- Analysis skills
- Paid parental leave
- Health savings account
14d
Transportation Manager
Ryder System —Terre Haute, IN
- $67,000 - $71,000 a year
- Urgently hiring
- Mid-level
- High school diploma or GED
- Analysis skills
- Paid parental leave
- Paid holidays
Quality Manager III
Amcor —Terre Haute, IN
- Full-time
- 7 years
- Microsoft Outlook
- Engineering
- Paid parental leave
- Health savings account
Quick Apply
Area Manager
Innovative Staff Solutions —Charleston, IL
- $24 - $28 an hour
- Full-time
- Customer service
- Mid-level
- Office
- Paid holidays
- Health insurance
Quick Apply
5h
Warehouse Manager
ENTEK —Terre Haute, IN
- Full-time
- Computer literacy
- Office
- Forklift
Quick Apply
6d
SUPERVISOR-LABORATORY-UHR LAB
Union Health —Terre Haute, IN
- Email
- Analysis skills
- Bachelor's degree
- Senior level
- 403(b) matching
- Tuition reimbursement
Maintenance Manager
FITESA TERRE HAUTE INC —Terre Haute, IN
- Bachelor of Science
- Writing skills
- Engineering
Quick Apply
STORE PERISHABLE MANAGER - DGPP
Dollar General —Paris, IL
- $16.50 - $17.00 an hour
- Full-time
- Merchandising
- Mid-level
- High school diploma or GED
- Paid parental leave
- Health insurance
Plant Manager - Ready Mix Concrete - Terre Haute
Smyrna Ready Mix, LLC —Terre Haute, IN
- Full-time
- Construction experience
- Senior level
- Communication skills
- Paid holidays
- Disability insurance
Culinary Manager
Majestic Care of Deming Park —Terre Haute, IN
- Full-time
- ServSafe
- Computer literacy
- English
- Paid holidays
- Life insurance
Quick Apply
1d

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Utilization Review Manager - SUD

Anabranch Recovery Center -
Terre Haute, IN

Quick Apply

Job Details

Full-time
14 days ago

Qualifications

Collaborate with healthcare professionals
CPR Certification
Staff supervision
Addiction counseling
Healthcare staff management
Team supervision
BLS Certification
Social service program staff supervision
Substance abuse treatment center experience
High school diploma or GED
Utilization management
Substance abuse
Resource utilization in healthcare
Concurrent review in utilization management
Experience working with individuals with substance use disorders
Cross-functional communication

Full Job Description

Utilization Review Manager - SUD | Anabranch Recovery Center | Terre Haute, Indiana

About the Job:

The Utilization Management Manager is responsible for the overall management of the UM department by leading and facilitating review of assigned admissions, continued stays, utilization practices and discharge planning according to approved clinically valid criteria. Directs and manages the day-to-day operations and supervision of staff to obtain coverage for clients, monitors the progress of all UR cases and insurance appeals, problem solves when necessary and mitigates all issues with utilization. Monitors utilization of services and optimizes reimbursement for the facility while maximizing use of the client’s provider benefits for their needs. This position is onsite at the facility and is not a remote position.

Roles and Responsibilities:

ESSENTIAL FUNCTIONS:

Assigns all clients to Utilization Review staff and supervises staff to ensure staff are completing insurance verifications on time and compliant with regulatory standards and requirements.
Ensures staff are competent to review medical records of clients for appropriateness of level of care at admission and at intervals determined by documentation in medical record and to communicate client insurance status and needs with all disciplines.
Identifies and prioritizes issues of importance, including those priority issues as set for by leadership. Collaborates with department leaders and corporate leaders, as needed.
Communicates instructions, expectations and timelines clearly and concisely.
Leads a team of highly engaged members through hiring, orienting, performance assessment and management, motivating, training, scheduling, and coaching to meet department goals and ensure effective and efficient department operation.
Maintains productivity levels that are aligned with client census, curtailing unnecessary overtime and/or excessive staff work hours.
Manages staff scheduling and maintains an updated plan for contingency staffing.
Maintains accountability expectations for self and staff in all areas of job performance.
Engages staff in quality and safety basics to ensure sustained, measurable compliance.
Identifies staff educational needs and ensures they are addressed with education programs that are attended by staff.
Hold staff accountable for non-compliance and client safety concerns, as well as attendance, following policies, behavior, and adherence to code of conduct.
Works closely with Admissions Department to ensure client information is accurate and pre-certification is complete. Reviews application for client admission and approves admission or refers case to utilization review committee for review and course of action when case fails to meet admission standards.
Manages any discrepancies regarding stated benefit information and insurance verification, need for updated benefits or follow-up on a problem with a pre-certification from admissions.
Appeals all denials ensuring accuracy of information and effective coordination of correspondence.
Analyzes client records to determine appropriateness of admission, treatment, and length of stay to comply with government and insurance company reimbursement policies. Ensures charting deficiencies are minimized and corrected timely by responsible staff. Identifies and forwards charts for review based on outlying data to the Medical Director.
Analyzes insurance, governmental and accrediting agency standards to determine criteria concerning admissions, treatment, and length of stay of clients.
Compares client’s medical records to established criteria and confers with medical, clinical, nursing, and other professional staff to determine appropriateness of treatment and length of stay. Communicates and coordinates information with business office to recognize and resolve potential payment issues.
Conducts and oversees concurrent and retrospective reviews for all clients. Assists review committee in planning and holding mandated quality assurance reviews.
Acts as a liaison between Medicaid reviewers and the staff completing required paperwork to facilitate the Utilization Review process.
May be required to provide onsite coverage for other programs when needed, develops, and executes new programs according to market needs and may provide training, case consultation and Administrator On Call coverage during and after program hours as needed.
May perform Leadership Rounds as assigned to include observation and immediate identification of environment of care, safety, and infection control concerns, as well as real time education of new facility processes.

ADDITIONAL RESPONSIBILITIES:

Develops and implements program policies and procedures that guide the provision of services.
Maintains regular and reliable attendance.
Meets expectations as an exempt employee to work additional hours as required to meet facility needs and project deadlines.
Maintains professionalism and confidentiality of facility employees and clients.
Performs other duties as assigned.

EDUCATION/EXPERIENCE/SKILL REQUIREMENTS:

High School Diploma or equivalent required. Graduation from an accredited school of nursing OR a Bachelor's degree in social work, behavioral or mental health, or other related health field preferred.
Two or more year's clinical experience in a substance abuse setting required.
Two or more years’ experience in medical/psychiatric utilization management required.
Comprehensive understanding of the admission, concurrent, continued stay, and retrospective reviews using the established facility criteria.
Ability to communicate professionally and effectively with multidisciplinary team members, managed care organizations and business office, providing needed information in a logical, concise manner using technical language that accurately describes client’s condition.

LICENSES/DESIGNATIONS/CERTIFICATIONS:

Current licensure as an LPN or RN or current clinical professional license or certification, as required, within the state where the facility provides services.
CPR and de-escalation certification required (training available upon hire and offered by facility).
First aid may be required based on state or facility requirements.

SUPERVISORY REQUIREMENTS:

Minimum of one year supervisory experience in clinical setting/utilization required.

Why Anabranch Recovery Center?Anabranch Recovery Center offers a comprehensive benefit plan and a competitive salary commensurate with experience and qualifications. Qualified candidates should apply by submitting a resume. Anabranch Recovery Center is an EOE.

Veterans and military spouses are highly encouraged to apply. Summit BHC is dedicated to serving Veterans with specialized programming at our treatment centers across the country. We recognize and value the unique strengths of the military community in supporting our mission to serve those who have served.

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Refine Your Search

quality compliance manager jobs in paris, il

Utilization Review Manager - SUD

Quality Manager

Quality Assurance Manager

Quality Compliance Manager

Quality Control Manager

Quality Control Manager

Quality Control Manager

SURGERY CENTER MANAGER

MANAGER of NON-INVASIVE CARDIOLOGY

Dispensary General Manager

Plant Manager

Transportation Manager

Quality Manager III

Area Manager

Warehouse Manager

SUPERVISOR-LABORATORY-UHR LAB

Maintenance Manager

STORE PERISHABLE MANAGER - DGPP

Plant Manager - Ready Mix Concrete - Terre Haute

Culinary Manager

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