Assistant Director, Nursing-Utilization Management

Lincoln Medical and Mental Health Center is one of New York City's premier acute care hospitals. Located in Downtown Bronx, Lincoln is a teaching hospital renowned for its Centers of Excellence, and a recognized industry leader in the implementation of state-of-the art medical technology and best practices. Our team of highly trained and caring medical professionals is dedicated to providing the highest quality health care that is safe, compassionate, culturally competent and patient-centered. Comprehensive services are offered in three major primary care areas: Medicine, Pediatrics, and Women's Health in addition to more than eighty (80) specialty services. At Lincoln, the safety and comfort of our patients is our number one priority.

At NYC Health + Hospitals, our mission is to deliver high quality care health services, without exception. Every employee takes a person-centered approach that exemplifies the ICARE values (Integrity, Compassion, Accountability, Respect, and Excellence) through empathic communication and partnerships between all persons.

Visit us at www.nyc.gov/html/hhc/lincoln.

Duties & Responsibilities

Purpose of Position:

Under general supervision of the Director of Utilization Management, assists with the planning, organizing, directing, coordinating, and evaluating of nursing services.

Essential Duties and Responsibilities:
1. Assume and exercise full responsibility and authority in overseeing the Adult Emergency Room Care Managers and Community Liaison Workers.
2. Oversee and supervise all administrative and managerial functions and processes of the Utilization Management Department in the absence of the director.
3. Formulate, review, implement, and enforce the policies and procedures of the Utilization Management Department.
4. Interview and hire applicants for employment into available job positions in the Utilization Management Department as well as supervise and conduct the orientation of new employees.
5. Supervision of staff of the Utilization Management Department.
6. Determine, outline, and review daily assignments for all staff of the Utilization Management Department.
7. Plan, prepare, manage, review, and approve the Time and Leave Schedule, including Annual Leave, Sick Leave, Compensatory Time, and all other Leaves of Absence, for all staff of the Utilization Management Department.
8. Review, edit, correct, and approve Timesheets for all staff of the Utilization Management Department, weekly.
9. Supervise the management of the Denial Management System of the Utilization Management Department. This involves reviewing all Denial Letters and determining if the Denials should be appealed or accepted and assigning the appealable denials to the Clinical Appeal Staff and Attending Physicians to appeal.
10. Supervise the writing of Medical and Behavioral Health Appeals of denial of hospitalization coverage for inpatients by health insurance companies as well as edit Appeal Letters written by the Clinical Appeal Staff and Attending Physicians.
11. Coordinate and ensure that, on a timely basis, all staff of the Utilization Management Department complete their Online or In-Person Annual In-Service Training and other mandated training for NYC Health + Hospitals/Lincoln employees.
12. Plan and implement Performance Improvement activities for the Utilization Management Department.
13. Promote for all staff all processes and activities that enhance personal and professional development including wearing professional attire to the workplace.
14. Conduct and complete Job Performance Evaluation annually for each staff of the Utilization Management Department when due.
15. Responsible for the counseling, institution of corrective action, issuance of warnings, and dispensation of other disciplinary actions for the staff of the Utilization Management Department in collaboration with the Human Resources and Labor Relations departments.
16. Ensure that requisitions for staff are prepared and submitted promptly in the event of staff vacancies or shortages in the department.
17. Perform any additional duties assigned by the Director of Utilization Management.

Minimum Qualifications
1. Licensed and currently registered to practice as a professional nurse in New York State, plus (2) or (3), below.
2. Masters Degree in Nursing Administration, Education, Clinical Specialty or equivalent field and five years of satisfactory nursing experience, of which three years shall have been in a supervisory or teaching capacity; or a Baccalaureate Degree in Nursing and six years of satisfactory nursing experience, four years of which shall have been in a supervisory or teaching capacity.
3. A satisfactory equivalent of education and experience. However, all candidates must be licensed and currently registered to practice as a Professional Nurse in New York State.

If you wish to apply for this position, please apply online by clicking the "Apply Now" button or forward your resume, noting the above Job ID #, to:

Lincoln Medical & Mental Health Center
Human Resources Department
234 Eugenio Maria De Hostos Blvd, (East 149th Street),
2nd Floor, Annex
Bronx, NY 10451
Attn: Recruitment Unit

NYC Health and Hospitals offers a competitive benefits package that includes:

• Comprehensive Health Benefits for employees hired to work 20+ hrs. per week
• Retirement Savings and Pension Plans
• Loan Forgiveness Programs for eligible employees
• Paid Holidays and Vacation in accordance with employees' Collectively bargained contracts
• College tuition discounts and professional development opportunities
• Multiple employee discounts programs