AIDS Healthcare Foundation

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Registered Nurse - Utilization Manager

Registered Nurse - Utilization Manager

Req No 
2018-7955
Job Locations 
US-FL-Fort Lauderdale
Category 
Managed Care
Type 
Regular Full-Time

More information about this job

WHO WE ARE

AIDS HEALTHCARE FOUNDATION
Does the idea of doing something that really makes a difference in people’s lives while being well-compensated intrigue you? Are you looking to work for an organization that encourages growth and success from each and every one of its employees?

 

If so, AIDS Healthcare Foundation is the place for you!
Founded in 1987, AIDS Healthcare Foundation is the largest specialized provider of HIV/AIDS medical care in the world.  Our mission is to provide cutting edge medicine and advocacy, regardless of ability to pay.  Through our healthcare centers, pharmacies, health plan, research and other activities, AHF provides access to the latest HIV treatments for all who need them.

BENEFITS AT AHF
AHF offers comprehensive benefits to help our employees do and be their very best! These benefits are intended to enhance employee physical, financial, spiritual, and professional health.

 

Health Plans:

PHP (HMO SNP)
PHP is a Medicare Advantage Prescription Drug health plan specifically for Medicare beneficiaries who are living with HIV and reside in Duval, Broward and Miami-Dade Counties.
PHP is the first HIV-specific special needs health plan approved by the Centers for Medicare & Medicaid Services (CMS). This plan covers routine doctor and specialist office visits, emergency and urgent care, hospitalization, and more. It also includes a prescription drug benefit for no monthly premium.
 
PHC Florida
PHC Florida is a Medicaid managed care plan designed specifically for HIV-positive individuals who are eligible for Medicaid and live in Broward, Miami-Dade and Monroe Counties.  PHC Florida is a Managed Medical Assitance (MMA) plan offered through Florida’s statewide Medicaid Managed Care Program

YOUR CONTRIBUTION TO OUR SUCCESS!

The Manager of Utilization Review contributes to the Managed Care Division success by effectively blending key initiatives to ensure positive patient outcomes while maintaining compliance with Federal and State regulatory requirements.  You will lead your team of professionals with a strong focus and vision while maintaining connections, and engaging the entire team to maximize their potential.  Through proficient planning, teaching, and collaboration, your team will work as one to actively participate in our member’s health care plans and maximize clinical efforts through participation in meetings, compliance with documentation and monitoring staff productivity. The result will conclude with quality care and cost effective utilization.

 

By using your leadership skills, you will motivate your team to greater heights by utilizing constructive criticism, forward thinking, education and positive reinforcement, yet monitor effectiveness through working reports, collecting data and identifying triggers to best help the team grow yet prevent needless use of resources.

 

The Manager of Utilization Review is the person the team looks to for support, guidance and professional growth.  By supporting your staff well, you will empower them to improve efforts with other departments, healthcenters and providers, and help achieve our goals to wisely use our resources so we can meet the needs of more members.

 

 

We at AIDS Healthcare Foundation believe that each individual is entitled to equal employment opportunities without regard to race, color, creed, gender, sexual orientation, gender identity, marital status, national origin, age, veteran status or disability. The right of equal employment opportunity extends to recruiting, hiring selection, transfer, promotion, training and all other conditions of employment.