DIR - UTILIZATION REVIEW / MGMT

UHS$75K — $95K *
Healthcare
5 - 7 years of experience
Job Overview by Ladders

Qualifications

  • Master's Degree in nursing, social work, mental health counseling, or related field required
  • Must possess relevant licensure (RN, APRN, LPC, LMSW, LCSW, etc.)
  • Minimum of five years of direct clinical experience in psychiatric or mental health treatment
  • At least one year of management experience in a related function preferred
  • Experience in patient assessment and treatment planning, including communication with external review organizations

Responsibilities

  • Oversee the Utilization Review coordinators as a working manager
  • Participate in treatment team meetings to collaborate with medical and therapeutic staff
  • Ensure initial precertification and continued authorization from insurance providers
  • Timely gather and communicate clinical criteria necessary for insurance processes
  • Enter supporting clinical criteria into computer systems (Midas)

Benefits

  • Referral Bonus Program
  • Challenging and rewarding work environment
  • Competitive compensation and generous paid time off
  • Excellent medical, dental, vision, and prescription drug plans
  • 401(K) with company match and discounted stock plan
  • Career development opportunities within UHS and its subsidiaries
Full Job Description
Responsibilities

Lighthouse Care Center of Augusta has been providing psychiatric services to the CSRA for more than 15-years. Located in Augusta, GA our 84-bed facility provides a therapeutic setting for those seeking treatment for mental illness. Lighthouse Care Center offers unique and individualized programming for adolescents and adults that sets us apart from many other treatment facilities, and our tenured team includes seasoned medical staff.

Website: https://www.LighthouseCareCenters.com

The Director of Utilization Review is a key member of the Lighthouse Case Management Team who will integrate and coordinate a patient centric therapeutic strategy with a keen focus on clinical content; ensuring that delivery of high-quality and cost-effective treatment is consistent with the mission, vision, and values of Universal Health Services and in accordance with government regulation, licensing and accreditation requirements. The Director of Utilization Review is r esponsible for the collection, analysis and articulation of required clinical data to insurance providers to obtain authorizations and ensure coordination with treatment services. The population served are patients' whose lives are disrupted or complicated by mental illness, behavioral disturbance, substance issues or inability to function or maintain in the community .

Job Duties/Responsibilities:
  • Working manager who oversees the Utilization Review coordinators
  • Participate in treatment team meetings, collaborate with physicians, therapist, nurses and pertinent staff
  • Authorizing entities to ensure initial precertification and continued authorization is achieved
  • Responsible for aspects relative to timely gathering clinical criteria, communication of clinical criteria, and entry of supporting clinical criteria into computer based systems (Midas)

Benefit Highlights
  • Referral Bonus Program
  • Challenging and rewarding work environment
  • Competitive Compensation & Generous Paid Time Off
  • Excellent Medical, Dental, Vision and Prescription Drug Plans
  • 401(K) with company match and discounted stock plan
  • Career development opportunities within UHS and its 300+ Subsidiaries!
  • More information is available on our Benefits Guest Website: uhsguest.com

Qualifications

EDUCATION:

Masters Degree in nursing, social work, mental health counseling, or related field required with licensure. (RN, APRN, LPC, LMSW, LCSW, etc)

EXPERIENCE:

A minimum of five (5) years direct clinical experience in a psychiatric or mental health treatment setting, including one year of managing a related function preferred. Experience in patient assessment, treatment planning and communication with external review organizations or comparable entities.

About UHS

UHS Careers

Joining UHS presents an unparalleled opportunity to become part of a leading team of healthcare professionals dedicated to making a difference. UHS, known for its commitment to innovation and leadership in the healthcare sector, offers a variety of job opportunities that cater to a diverse range of skills and experiences.

Explore Job Opportunities

UHS is actively hiring and offers a wide array of positions, from clinical roles to administrative support. Each position at UHS is designed to challenge team members while providing meaningful service to the community. Explore the current job openings and find a career path that suits professional aspirations and skills.

Internship Programs

UHS provides robust internship programs that offer hands-on experience in the healthcare industry. Internships are a cornerstone of professional development, giving participants a chance to deepen practical skills in a real-world setting. These programs are tailored to foster growth and prepare interns for a full-time position within the company.

Professional Growth and Development

UHS believes in nurturing the career growth of its team members through comprehensive professional development programs. These include leadership training, diversity training, and continuous education in the latest healthcare practices, ensuring that every team member has the opportunity to advance their career.

Benefits and Culture

Employment at UHS comes with competitive benefits designed to support the health, well-being, and financial security of each team member and their families. The company culture at UHS is built on a foundation of respect and inclusion, where diversity is celebrated and every voice is heard.

Networking and Innovation

UHS encourages a culture of innovation where team members are motivated to bring forward ideas that drive improvement and efficiency. Networking within the company is supported through various events and internal platforms, helping team members to connect, share insights, and collaborate on projects.

Applying for a Position

To apply for a position at UHS, candidates should prepare their resume to highlight relevant experience and skills. The interview process at UHS is thorough, aiming to assess not only the professional qualifications but also the alignment with the company’s values and culture. Interested candidates can visit the UHS Careers page to submit an application and learn more about the hiring process.

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