Under the direction of the Senior Director, Case Management, the Manager Utilization Review (UR) has responsibility for oversight of the development, implementation and performance management of the Utilization Review and Denials Prevention program across all Children’s Hospital of Philadelphia (CHOP) acute hospitals. The Manager Utilization Management is responsible for utilization review and authorization management services, to promote appropriate level of care, length of stay, and prevent payer denials. Manages daily operations, which include supervising the staff performing utilization management and denial prevention activities. This role functions as the internal resource on issues related to utilization review and management. The manager is responsible for carrying out assignments in a manner to assure success in financial management, human resources management, leadership, quality and operational management objectives.
The manager consistently demonstrates the ICARE values of CHOP and serves as a role model to other employees.