Director of Utilization Review

UHS • Gulfport, MS

8d

About The Position

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.
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.

Requirements

• Bachelor degree in Nursing or Master’s Degree in human services field preferred.
• Minimum of 2 years clinical experience and 1 year of management experience with case management and the utilization review process including concurrent reviews.
• Current license in the state of Missisippi, including RN, LMSW, LMFT, LPC

Nice To Haves

• Previous continuum of care experience highly preferred.

Responsibilities

• Assume responsibility for the functioning of the Utilization Review Department
• Provide utilization review services in a manner consistent with the philosophy and objectives of the facility
• Evaluate patient medical records to determine severity of patient’s illness and determines the appropriateness of level of care
• Serve as liaison for patients and hospital with insurance companies
• Negotiate and advocate for patient length of stay and level of care
• Oversee utilization review activities with other departments to ensure reimbursement for services provided by the hospital

Benefits

• 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

What This Job Offers

• Job Type: Full-time
• Career Level: Director
• Number of Employees: 501-1,000 employees