DIR - Utilization Review/ MGMT

UHS•Flowood, MS

12d•Onsite

About The Position

Brentwood Behavioral Healthcare is a provider of quality psychiatric treatment services for adults, children and adolescents. Our outpatient services are a convenient drive to areas in Hinds County, Madison County and Rankin County. We also provide inpatient services for those who need more structured treatment. As a leading provider of behavioral health services, our goal is to help individuals and families achieve optimal mental health, resulting in improved quality of life. Our dedicated team of professionals provides individualized treatment, meeting the personal needs of our customers in a secure and nurturing environment. Brentwood Behavioral Healthcare is a 133-bed acute psychiatric care facility located in Flowood, Mississippi. We are accredited by the Joint Commission of Accreditation of Healthcare Organizations and certified by Medicare, Medicaid and TRICARE®. We provide psychiatric treatment for depression, bipolar disorder, anxiety, schizophrenia, phobia and more. It is important these issues get treated so individuals are able to lead a healthy and happy life. Position Summary:The UR Director possesses knowledge of psychiatric clinical diagnosis and the ability to articulate those indicators professionally. The UR Director evaluates patient medical records to determine severity of patient’s illness and determining 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. The UR Director leads physician weekly staffing meetings and coordinates with physician’s outpatient offices for the purposes of billing. The UR Director has a working knowledge of all levels of care offered and appropriately manages patient benefits.

Requirements

Degree in nursing, social work, mental health/behavioral sciences, or related field. Combination of education and experience may be considered.
A minimum of five (5) years’ direct clinical experience in a psychiatric or mental health treatment setting.
Experience in patient assessment, family motivation, treatment planning and communication with external review organizations or comparable entities.
LMSW, LPC, RN or LVN licensure is required.

Nice To Haves

A minimum of one year of managing a related function is preferred.

Responsibilities

Evaluates patient medical records to determine severity of patient’s illness and determining 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.
Leads physician weekly staffing meetings and coordinates with physician’s outpatient offices for the purposes of billing.
Appropriately manages patient benefits.