PACE Utilization Manager RN (Central Valley PACE - Modesto)

Golden Valley Health Centers
Modesto, CA
Category Healthcare
Job Description
Provides utilization management functions, performs concurrent and retrospective utilization management reviews, and collaborates with clinical and interdisciplinary teams to ensure quality care and cost-effective services.

Requirements

  • Valid CA Driver's License, acceptable driving record, and vehicle insurance.
  • Detailed-oriented and organized.
  • Excellent written and verbal communication skills with specific ability to maintain accurate records.
  • Excellent customer service skills.
  • Ability to collect, organize, manage and report on large volumes of meaningful data for decision making while using spreadsheets or other data processing software.
  • Knowledge of basic statistical principles.
  • Skilled in establishing and maintaining effective working relationships with participants, coworkers, medical staff, and the public.
  • Skilled in identifying and recommending problem resolution.
  • Knowledge of safety and infection control requirements for healthcare facilities.
  • Demonstrated experience in quality assurance and performance improvement activities.
  • Proficient in Microsoft Office applications; advanced Microsoft Excel experience required.
  • Knowledge of State and Federal healthcare regulations.

Benefits

  • Medical (0 Deductible / $2,000 Individual; $4,000 Family Out-of-Pocket Max)
  • Dental
  • Vision
  • 403(b) with match
  • FSA plans
  • Gym discounts
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