Director - Utilization Review - Full-time

UHS • Bartlett, TN

9h

About The Position

Lakeside Behavioral Health System is seeking a Director of Utilization Review to oversee utilization management, including utilization review, case documentation, payer relationships, regulatory requirements, staff management, and department administration. The director supports the hospital’s overall success by promoting patient satisfaction, regulatory compliance, and optimal reimbursement.

Lakeside is a 365-bed, free-standing psychiatric hospital serving children, adolescents, young adults, adults, and seniors in the Memphis and Mid-South region. Its behavioral health and addictive disease programs address conditions including bipolar disorder, psychological trauma, depression, anxiety, mental illness, and substance use disorders.

Requirements

• Master’s degree in a healthcare field such as Nursing, Counseling, Psychology, or Social Work.
• Either 8–10 years of experience as a treatment team member in an acute inpatient psychiatric setting, or 5–7 years of utilization management experience involving mental health and substance abuse behavioral health disorders.
• Knowledge of managed care payer business practices, behavioral health hospital operations, and medical necessity determinations.
• Knowledge of DSM-V diagnostic codes and clinical assessment skills supporting patient evaluation.
• Ability to manage team productivity and compliance with required timelines.
• Excellent oral and written communication skills.

Nice To Haves

• Valid Tennessee RN license, LCSW, or LPC preferred.

Responsibilities

• Oversee utilization management, including utilization review, case documentation, payer relationships, regulatory requirements, staff management, and department administration.
• Support the overall success of the hospital.
• Promote patient satisfaction, regulatory compliance, and optimal reimbursement.
• Use data to identify trends.
• Manage team productivity and compliance with required timelines.
• Foster departmental engagement across the hospital through effective communication.

Benefits

• Competitive compensation
• Paid time off
• Medical, dental, vision, and prescription drug plans
• 401(k) with company match
• Discounted stock plan
• SoFi Student Loan Refinancing Program
• Tuition savings for nursing education through Chamberlain University
• Pet insurance
• Career development opportunities within UHS and its subsidiaries

What This Job Offers

• Job Type: Full-time
• Career Level: Director