Director of Utilization Review

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

Qualifications

  • Bachelor's degree in Nursing or Master's in human services field preferred
  • Minimum 2 years clinical experience
  • At least 1 year management experience with case management and utilization review
  • Experience with concurrent reviews is essential
  • Current license in Mississippi as RN, LMSW, LMFT, or LPC

Responsibilities

  • Manage the Utilization Review Department effectively
  • Evaluate patient medical records to assess illness severity
  • Determine appropriateness of level of care for patients
  • Act as liaison between patients, hospital, and insurance companies
  • Negotiate for patient length of stay and required level of care
  • Coordinate with other departments for reimbursement activities

Benefits

  • Challenging and rewarding work environment
  • Career development opportunities within UHS and its subsidiaries
  • Excellent Medical, Dental, Vision, and Prescription Drug Plan
  • 401(K) with company match and discounted stock plan
  • Generous Paid Time Off
  • Free Basic Life Insurance
  • Tuition Reimbursement
Full Job Description
Responsibilities

We are now offering a $5,000 sign-on bonus for our Utilization Review Director opening!

Gulfport Behavioral Health System is an acute behavioral health hospital on the Mississippi Gulf Coast providing inpatient, partial hospitalization and outpatient services to children, adolescents, and adults. We have served our community for over 30-years and our Patriot Support Program provides inpatient around-the-clock mental health treatment to help military members and their families, veterans, and first responders cope with stressful issues every day.

Visit us online at: https://gulfportbehavioral.com

The Director of Utilization Review : will assume responsibility for the functioning of the Utilization Review Department and provide utilization review services in a manner consistent with the philosophy and objectives of the facility; evaluates patient medical records to determine severity of patient's illness and determines the appropriateness of level of care; serves as liaison for patients and hospital with insurance companies; negotiates and advocates for patient length of stay and level of care; oversees utilization review activities with other departments to ensure reimbursement for services provided by the hospital.

Benefit Highlights:
  • Challenging and rewarding work environment
  • Career development opportunities within UHS and its Subsidiaries
  • Competitive Compensation
  • Excellent Medical, Dental, Vision and Prescription Drug Plan
  • 401(K) with company match and discounted stock plan
  • Generous Paid Time Off
  • Free Basic Life Insurance
  • Tuition Reimbursement
If you would like to learn more about this position before applying, please contact Madison Reddell, Clinical Recruiter, at [redacted] or by phone at [redacted].

Qualifications

Education: Bachelor degree in Nursing or Master's Degree in human services field preferred.

Experience: Minimum of 2 years clinical experience and 1 year of management experience with case management and the utilization review process including concurrent reviews. Previous continuum of care experience highly preferred.

Licensure: Current license in the state of Missisippi, including RN, LMSW, LMFT, LPC

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.

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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.

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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.

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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.

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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.

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