Clinical Nurse Supervisor Utilization Management

The Associate Clinical Manager (aka Clinical Nurse Supervisor) is responsible for managing a unit/department by implementing and maintaining specific policies, procedures, and guidelines; leading team members in providing direct patient care by demonstrating expert clinical knowledge; ensuring compliance with quality and safety initiatives and practices; and partnering with a multidisciplinary team in meeting the clinical needs of patients and families The Associate Clinical Manager also provides leadership and management to unit/department team members. Finally, the Associate Clinical Manager serves as a charge nurse by preparing schedules and assigning team members to patients; overseeing the admission, discharge, and general flow of patients; and monitoring and ordering medicines and supplies.

This position will oversee team members serving in the Utilization Review RN position. Duties of that position are: The Utilization Review RN participates as a member of a multidisciplinary team to support medical necessity reviews, ensure compliance, and actively participate in denial mitigation. It is a collaborative approach that uses pre-established guidelines and criteria to perform review activities to ensure the proper utilization of hospital services and payment of those services by Medicare, Medicaid, and other third-party payors. This position will also oversee the non-clinical team members who are part of this department.

Department Name: Utilization Management
Job Status: full time, 40 hours per week, eligible for benefits
Shift: Day shift Monday through Friday 0800 - 1630

This position will be primarily remote but there may be occasions when you are expected to work onsite at one of the CHCO locations. The specific details will be discussed in the interview process, and subject to change at our discretion. Team members in the Utilization Review RN role also work hybrid - mostly remote, with the expectation they will come to campus when necessary.

This position is eligible for relocation assistance, if relocating from 100 miles or greater.

Duties & Responsibilities

An employee in this position may be called upon to do any or all of the following essential functions. (These examples do not include all of the functions which the employee may be expected to perform.)

* Manages the implementation and maintenance of unit/department specific policies, procedures, and guidelines while ensuring consistency with evidence-based practice and organizational policies, standards, and procedures.
* Leads unit/department team members in providing direct patient care by demonstrating expert clinical knowledge and promoting the application of the Professional Practice Model and Professional Standards in daily work.
* Serves as a charge nurse by preparing schedules and assigning team members to patients; overseeing the admission, discharge, and general flow of patients; and monitoring and ordering medicines and supplies. Works with team members to create individualized plans of care to meet a patient needs.
* Interprets and explains regulatory standards and hospital policies, procedures, and rules to employees and ensures compliance with applicable quality and safety initiatives and practices.
* Ensures staffing resources are utilized appropriately and shifts resources to meet both patient and unit needs.
* Partners with a multidisciplinary team in meeting the clinical needs of patients and families. Rounds with patients, families and team members to promote patient family experience and quality patient care.
* Resolves operational and patient/family issues, making decisions that are inclusive of multiple perspectives and solves underlying problems.
* Assists team members in achieving unit outcomes, performance and professional development standards; identifies opportunities for continual improvement.
* Champions clinical practice and professional growth by working with the CNE/CNS to meet the educational needs of the unit/department and by monitoring and evaluating staff competencies. Develops, coaches, and evaluates team members. Mentors team members in creating/evaluating projects focused on improving clinical practice.
* Provides advice to Clinical Manager on decisions involving hiring, terminations, promotions, and disciplinary actions as required.
* Monitors expenditures for unit/department and participates in the development of budget recommendations.

Position requires regular and predictable attendance.
Employees are held accountable for all duties of this job.

Minimum Qualifications

* EDUCATION - Bachelor's degree in Nursing. Master's degree in Nursing or a directly related health care field is preferred.
* EXPERIENCE - Three years of clinical experience. Previous experience in utilization review/utilization management is preferred.
* LICENSURE - Registered Nurse (RN)
* CERTIFICATION(S) - BLS/CPR from the American Heart Association with at least 6 months left before expiration is required upon hire. ANCC recognized certification in clinical specialty. Depending on the unit/department, employees may also be required to have a Pediatric Advanced Life Support (PALS), Adult Advanced Life Support (ACLS), and/or Emergency Nursing Pediatric Course (ENPC).

Salary Information
Pay is dependent on applicant's relevant experience.

Annual Salary Range (Based on 40 hours worked per week): $105,046.99 to $157,570.49

Benefits Information
Here, you matter. As a Children's Hospital Colorado team member, you will receive a competitive pay and benefits package designed to take care of your needs that includes base pay, incentives, paid time off, medical/dental/vision insurance, company provided life and disability insurance, paid parental leave, 403b employer match (retirement savings), a robust wellness program, and access to professional development tools, including an education benefit to help you advance your career.

As part of our Total Rewards package, Children's Colorado offers an annual employee bonus program that rewards eligible team members based on organizational performance. If organizational goals are met for the year, the bonus is paid out the following April.

Children's Colorado delivers annual base pay increases to eligible team members based on their performance over the previous year.

EEO Statement
It is our intention that all qualified applicants be given equal opportunity and that selection decisions be based on job-related factors. We do not discriminate on the basis of race, color, religion, national origin, sex, age, disability, or any other status protected by law or regulation. Be aware that none of the questions are intended to imply illegal preferences or discrimination based on non-job-related information. The position is expected to stay open until the posted close date. Please submit your application as soon as possible as the posting is subject to close at any time once a sufficient pool of qualified applicants is obtained.

Colorado Residents: In any materials you submit, you may redact or remove age-identifying information such as age, date of birth, or dates of attendance at or graduation from an educational institution. You will not be penalized for redacting or removing this information.