About Us

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Here at Baylor Scott & White Health we promote the well-being of all individuals, families, and communities. Baylor Scott and White is the largest not-for-profit healthcare system in Texas that empowers you to live well.

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Our Core Values are:

\n\nWe serve faithfully by doing what's right with a joyful heart.\nWe never settle by constantly striving for better.\nWe are in it together by supporting one another and those we serve.\nWe make an impact by taking initiative and delivering exceptional experience.\n\n

Benefits

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Our competitive benefits package empowers you to live well and provides:

\n\nEligibility on day 1 for all benefits\nDollar-for-dollar 401(k) match, up to 5%\nDebt-free tuition assistance, offering access to many no-cost and low-cost degrees, certificates and more\nImmediate access to time off benefits\n\n

At Baylor Scott & White Health, your well-being is our top priority.

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Note: Benefits may vary based on position type and/or level

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Job Summary

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As a Manager for Utilization Review, you guide and supervise staff. You oversee care coordination across all business areas. You help manage patients and speed up care transitions. You assess programs and improve them. You evaluate workflow and system design to meet requirements.

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Salary

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The pay range for this position is $47.05 (entry-level qualifications) - $72.93 (highly experienced) The specific rate will depend upon the successful candidate’s specific qualifications and prior experience.

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Essential Functions of the Role

\n\nManage Care Coordination operations daily, including supervision of staff, resource management, and budget control. Departments involved are Utilization Management, Case Management, and Disease Management.\nEnsure all regulations, policies and procedures of the division are strictly adhered to during daily operations.\nPartner with both internal and external teams to guarantee top-notch service for all stakeholders, including members and providers.\nDevelop a comprehensive knowledge of the medical management system, which involves in-depth understanding of the system configuration.\nAssess system changes' impact, configure as needed, document changes carefully, and track changes to meet requirements.\nContinuously improve policies, procedures, resources.\nRegularly audit and train to meet business goals effectively.\nPartner with teams for good care, lower costs. Move patients quickly through care levels for better outcomes.\nManage continuing care for all members, focusing on case management for specific populations and members.\n\n

Key Success Factors

\n\nDemonstrable knowledge in discharge planning, case management, utilization review and different care levels.\nOutstanding written and verbal communication skills, which are maintained professionally in all interactions.\nAn expertise of healthcare systems and healthcare plans.\nCapability to adjust to changes in the medical management system and assess their impact in meeting regulatory and business requirements.\nSkills in operational decision-making about work processes including quality and productivity standards, setting clear goals for employees and project teams.\nAbility to align resource allocation recommendations with broader goals for effective scheduling and goal realization.\nProficiency in making effective recruitment and termination recommendations.\nCapacity to evaluate and propose changes to policies and implement procedures that influence the managed organization.\nUnderstanding business operations involves planning, goal setting, budgeting, employee compensation, risk management, and compliance activities.\nFamiliarity with general computer applications like Microsoft Office, information security software, scheduling and payroll systems, email, and electronic medical documentation.\n\n

Belonging Statement

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We believe that all people should feel welcomed, valued and supported, and that our workforce should be reflective of the communities we serve.

Qualifications

Possess a Bachelor's degreeHave at least five years of relevant work experienceHold a valid registration as a Registered Nurse