Utilization Review Case Manager

UHS • Olive Branch, MS

106d

About The Position

Parkwood Behavioral Health System provides behavioral health and chemical dependency services to the Mid-South region and has been in business since 1987. We are located in Desoto County, in the northwest corner of Mississippi and approximately 7 miles south of Memphis. As treatment options and patient care innovations have continued to become available we strive to provide the highest level of quality care to our patients. At Parkwood, our caring staff focus on providing compassionate care to meet the needs of individuals, families and communities. We offer a full continuum of care that provides treatment options to meet the individual needs of adults, adolescents and children. Parkwood Behavioral Health System includes a 148-bed inpatient acute and residential care facility, as well as partial hospitalization and intensive outpatient programs. The Case Manager provides utilization review services in a manner consistent with the philosophy and objectives of the facility. The Case Manager 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 human services field preferred.
• Minimum of 2 years clinical experience.
• 1 year of management experience with case management and the utilization review process including concurrent reviews.
• Previous continuum of care experience highly preferred.
• LPN or RN preferred.
• Prefer knowledge of case management, discharge planning, age specific growth and development, crisis and behavior management.

Responsibilities

• Evaluate patient medical records to determine severity of patient’s illness.
• Determine 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.

What This Job Offers

• Job Type: Full-time
• Career Level: Mid Level
• Education Level: Bachelor's degree
• Number of Employees: 1,001-5,000 employees