What You'll Be Doing:

As a Manager, Utilization Review, you will hire, evaluate, and supervise Utilization Review Specialists and oversee Utilization Review operations. This role coordinates with Clinical Managers and Directors, Physicians, Business Office, and Managed Care Organizations to assure the smooth operation of Utilization Review functions and the provision of optimal patient care.

ESSENTIAL DUTIES AND RESPONSIBILITIES:

• Clinically supervises teammates in 1:1 and group settings; provides in-moment assistance on escalated issues. Provides oversight to assigned team by supervising, guiding, and directing employees to be effective team members. Ensures that everyone is equipped with the right skills, tools, and talents necessary for executing their duties. Using the established people processes (performance, development, succession, and career) to ensure that the team's level of performance and capabilities meet current and future standards.
• Advocates for optimal patient care in clinical care determination reviews by proactively reviewing and synthesizing the medical record for discussion with licensed mental health counselors and social workers and RNs at managed care organizations
• Liaison with regional management teams to discuss clinical issues and facilitate solutions to situations that involve the UR process
• Oversees regional caseload allocation
• Attends treatment team meetings to share information and represent UR department; shares clinical documentation quality concerns

Education Requirements:

• Graduate Degree - Master's degree in psychology, counseling or social work. Alternatively, a bachelor's in Nursing

License and Certification Requirements

• RN, IF nurse (Required)
• Full clinical licensure, if mental health. (Required)

Knowledge, Skills and Abilities:

• 4 to 6 years Utilization review experience(Required)
• 2 years post-degree mental health experience in direct patient care (Required)
• 2 years management experience (Preferred)
• Willingness to work occasional night/weekends

Location & Schedule:

This position is posted as remote; however, per company policy, candidates residing within a 35-mile radius of ZIP code 80230 will be required to follow a hybrid schedule, even if they applied to the remote posting.

• Remote: Mondays and Fridays
• On-site in our Denver Office: Tuesdays, Wednesdays, and Thursdays

The compensation range for this position is based upon candidate experience and market expectations.

Colorado pay range

$93,000-$117,000 USD

What We Offer

At ERC Pathlight, caring for people is our mission and that begins with caring for our own team. Your well-being matters, and our benefit program is designed to support every part of your life.

We offer competitive compensation; comprehensive medical, dental, and vision coverage; generous Paid Time Off; Parental Leave benefits; Retirement benefits; and tuition reimbursement to help you continue growing in your career.

We also recognize that mental health is part of every person's experience. That's why we strive to create a workplace where you feel supported, seen, and encouraged-personally, professionally, and at home.

When you thrive, you can do your best work. And your best work changes lives.