Utilization Management Manager - Full Time

UHS•Fayetteville, AR

3d•Onsite

About The Position

We are currently hiring a full time Utilization Management Manager for Springwoods Behavioral Health. The Utilization Management Manager develops, coordinates, and implements the Utilization Management Plan and Program of Springwoods Behavioral Health. The manager of Utilization Management oversees utilization management including, but not limited to utilization review, day-to-day function of the department, case documentation, payer relationships, regulatory requirements, staff management, and department administration. The UM Manager ensures that the development, implementation and evaluation of department policies and procedures are in compliance with all corporate, The Joint Commission, CMS, federal, state and local regulations. The Utilization Management Manager will be responsible for oversight of the hospital’s concurrent review process, medical necessity audits to manage the length of stay, and denial and appeal management. Supports the overall success of the hospital and promotes patient satisfaction, regulatory compliance and optimal reimbursement. This position contributes to the hospital’s philosophy, objectives, education, and quality improvement efforts, while providing guidance. Springwoods Behavioral Health, an 80-bed behavioral health facility located in Fayetteville, Arkansas, provides acute inpatient treatment for adolescent, adult, and specialty program for women. The hospital also offers outpatient treatment. Our six-acre campus is adjacent to a 123-acre Audubon Wildlife and Bird Sanctuary, which is held in perpetuity and cannot be developed from its natural state. This provides Springwoods with a peaceful setting for those embarked on the road to recovery. Visit us online at: https://www.springwoodsbehavioral.com/ About Universal Health Services One of the nation’s largest and most respected providers of hospital and healthcare services, Universal Health Services, Inc. (UHS) has built an impressive record of achievement and performance. Growing steadily since its inception into an esteemed Fortune 500 corporation, annual revenues were $13.4 billion in 2022. During the year, UHS was again recognized as one of the World’s Most Admired Companies by Fortune; and listed in Forbes ranking of America’s Largest Public Companies. Headquartered in King of Prussia, PA, UHS has approximately 94,000 employees and continues to grow through its subsidiaries. Operating acute care hospitals, behavioral health facilities, outpatient facilities and ambulatory care access points, an insurance offering, a physician network and various related services located all over the U.S. states, Washington, D.C., Puerto Rico and the United Kingdom. www.uhs.com EEO Statement All UHS subsidiaries are committed to providing an environment of mutual respect where equal employment opportunities are available to all applicants and teammates. UHS subsidiaries are equal opportunity employers and as such, openly support and fully commit to recruitment, selection, placement, promotion and compensation of individuals without regard to race, color, religion, age, sex (including pregnancy, gender identity, and sexual orientation), genetic information, national origin, disability status, protected veteran status or any other characteristic protected by federal, state or local laws. Avoid and Report Recruitment Scams We are aware of a scam whereby imposters are posing as Recruiters from UHS, and our subsidiary hospitals and facilities. Beware of anyone requesting financial or personal information.

Requirements

Graduate of an accredited RN, BSN Program or a Master’s Degree in Social Work, Psychology, Counseling, or other Human Service fields.
Registered Nurse license to practice in state of Arkansas or Current LCSW, LAC, LPC, LMSW in state of Arkansas.
Five to eight years of clinical experience in a psychiatric inpatient setting is preferred.
Prior experience in the utilization and review function is highly preferred.
Previous management experience in supervision or administration is preferred.
The ability to organize tasks related to the accomplishment of hospital goals and objectives.
Ability to work in a professional manner with physicians, mental health professionals, outside agencies, and support staff.
Ability to work with child, adolescents, and adult populations as demonstrated through educational accomplishment or work experience.
A working knowledge of JCAHO patient rights standards, and any other applicable federal and state laws and regulations governing mental health care facilities relating to Patient’s rights and utilization review.
Successful completion of CPR Certification, Verbal De-esculation and Handle with care witin the the first 30 days.
Able to work overtime and flexible hours.

Responsibilities

Develops, coordinates, and implements the Utilization Management Plan and Program.
Oversees utilization management including utilization review, day-to-day function of the department, case documentation, payer relationships, regulatory requirements, staff management, and department administration.
Ensures compliance with all corporate, The Joint Commission, CMS, federal, state and local regulations for department policies and procedures.
Responsible for oversight of the hospital’s concurrent review process, medical necessity audits to manage the length of stay, and denial and appeal management.
Supports the overall success of the hospital and promotes patient satisfaction, regulatory compliance and optimal reimbursement.
Contributes to the hospital’s philosophy, objectives, education, and quality improvement efforts, while providing guidance.