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At CoreCivic, our employees are driven by a deep sense of service, high standards of professionalism and a responsibility to better the public good. CoreCivic is currently seeking a **Manager, Health Services Audits** located at our corporate office in Brentwood, TN. Come join a team that is dedicated to making an impact for the people and communities we serve.

_This position would require a hybrid work schedule of 3 days per week onsite and 2 days remote out of our Brentwood, TN office location._

_This position will pay $82,000 - $97,400 with a 10% bonus eligible._

SUMMARY:

The Manager, Utilization Management/Case Management provides Utilization Review and Case Management functions for the organization under the direction of the Senior Director, Case Management and within the established policies and procedures. Reviews preadmission, concurrent and retrospective review for all patients, completes assessments for the purpose of identifying discharge-planning needs, and provides discharge-planning services for select patient populations. Assists with daily hospital case management operations and is accountable for achieving established outcomes through actively engaging interdisciplinary teams and external stakeholders.

ESSENTIAL FUNCTIONS:

The incumbent should be able to perform all of the following functions at a pace and level of performance consistent with the job performance requirements.

+ Provides oversight of medical case management activities to ensure efficiency and maintain compliance with company policies, standards, and government laws and regulations.

+ Manages a team of utilization management nurses.Provides direction and supports staff in the development of cost-effective plans for high-risk, high-cost cases by assisting healthcare providers with alternative treatment plans.

+ Supervises staff in the performance of their duties and evaluates as prescribed by company policy.This includes onboarding new employees, evaluating performance and preparing written performance reviews, listening to concerns and effectively resolving problems or issues, taking corrective or disciplinary action, developing work schedules for staff, and approving leave requests.

+ Collaborates with management for oversight of the utilization review process to ensure services being rendered are appropriate and meet guidelines.

+ Maintains ongoing dialogue with senior director and other healthcare providers to ensure effective implementation of care plans.

+ Reviews the discharge planning process to ensure effective patient transfers and transitions of care.

+ Compiles, evaluates, and reports statistics and trends to senior director and utilizes the information to facilitate process improvement.

+ Domestic U.S. travel may be required.

QUALIFICATIONS:

+ Graduate from an accredited college or university with a Bachelor's degree in Nursing is required.

+ Must possess current RN licensure in the state of employment/assignment or a nursing compact state.

+ Advanced degree in nursing or related healthcare field is preferred.Three years of hospital, health care system, or health plan nursing experience is required.

+ Case Management certification credentialed by ACMA or CCMC or BLS provider certification is required.

+ Knowledge of CMS guidelines and experience working with payer specific guidelines and contractual rules.

+ Proficiency in Microsoft Office applications required.

_CoreCivic is a Drug-Free Workplace and EOE – including Disability/Veteran._