Responsibilities Oversees utilization management including, but not limited to: utilization review, case documentation, payer relationships, regulatory requirements, staff management and department administration. Supports the overall success of the hospital and promotes patient satisfaction, regulatory compliance and optimal reimbursement.
This opportunity provides the following: - Challenging and rewarding work environment
- Career development opportunities within UHS and its 300+ subsidiaries
- Competitive Compensation & Generous Paid Time Off
- Excellent Medical, Dental, Vision and Prescription Drug Plans
- 401k with company match and discounted stock plan
- SoFi Student Loan Refinancing Program
- Tuition savings to continue your nursing education with Chamberlain University
- Pet Insurance
- More information is available on our Benefits Guest Website: benefits.uhsguest.com.
Qualifications Job Requirements Education: Masters prepared healthcare leader/director (Nursing, Counseling, Psychology or Social Work).
E
xperience: A minimum of 8-10 years of experience working in an acute inpatient psychiatric setting as a treatment team member or 5-7 years of experience in utilization management for both mental health and substance abuse behavioral health disorders
Licensure/Certification: Valid TN RN license, LCSW, or LPC preferred.
Knowledge: Knowledge of managed care payer business practices, behavioral health hospital operations and medical necessity determinations. Knowledge of Diagnostic and Statistical Manual of Mental Disorders (DSM-V) diagnostic codes with corresponding clinical assessment skills that support patient evaluation. Experience using data to identify trends. Ability to manage team productivity and compliance with required timelines. Excellent oral and written communication skills that drive departmental hospital engagement.
