Manager Utilization Review
KVC Health Systems•St. Louis, MO
•Onsite
About The Position
The Utilization Review Manager provides engaging and inclusive leadership to a department responsible for managing all aspects of patient stays relative to health plan interfaces. Operating at the fast pace of short-term hospitalization, you will partner with physicians, nurses, and therapists to ensure timely, accurate assessments and appropriate referrals. You will supervise Utilization Review Specialists, ensuring compliance with Camber policies while fostering a solutions-focused environment built on the values of respect, accountability, and integrity.
Requirements
- All applicants must be at least 20 years of age.
- Bachelor’s degree in a human service field such as social work, education, sociology, psychology, counseling, human relations, or criminal justice.
- A minimum of two years of experience in Utilization Review and at least one year of experience in a leadership role.
- Valid driver’s license and auto insurance.
- Intermediate proficiency with Microsoft Office, specifically Word, Excel, and Outlook.
- Strong command of the English language, both verbal and written, to conduct official administrative and operational business.
Nice To Haves
- Bachelor’s degree in social work with licensure through the Missouri Division of Professional Registration (MOPRO) or the Kansas Behavioral Sciences Regulatory Board.
- Experience working with economically disadvantaged, vulnerable, or at-risk youth and young adults.
Responsibilities
- Direct supervision of Utilization Review Specialists to ensure task completion and policy compliance.
- Managing telephonic interfaces with health plans to provide clinical information developed by treatment teams.
- Leading departmental operations including oversight of responsibilities, performance evaluations, and approval of workflow.
- Compiling and managing utilization review data with high attention to detail and accuracy.
- Communicating effectively with diverse constituencies, including families, community partners, and service agencies.
- Maintaining the highest standards of confidentiality and adhering to JIAC and KVC regulatory procedures.
- Participating actively in treatment team meetings and staff conferences to ensure continuity of care.
Benefits
- Work Wellbeing Score of 83
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What This Job Offers
Job Type
Full-time
Career Level
Manager
