Utilization Review Director

Lifepoint Health • Georgetown, TX

7h

About The Position

The responsibility of the UR Director is to ensure the utilization review activities are completed accurately and timely. This includes the precertification and recertification, peer to peer process, and appeals. The UR Director will report consistently and accurately to the CEO or delegate the authorization status of current patients and appeals. The Director will ensure that all UR staff members follow department and facility procedures. The Director will further ensure that communication with all relevant departments, but especially CBO and Business Office, meets staff and patient needs. The UR Director will report consistently and accurately to the CEO or delegate the authorization status of current patients and appeals.

Requirements

• Bachelor’s degree required.
• Previous utilization review experience in a psychiatric healthcare facility preferred.
• Current unencumbered clinical license strongly preferred.
• CPI and CPR preferred within 30 days of hire.
• May be required to work flexible hours.

Nice To Haves

• Master’s degree preferred.
• Previous utilization review experience in a psychiatric healthcare facility preferred.
• Current unencumbered clinical license strongly preferred.
• CPI and CPR preferred within 30 days of hire.

Responsibilities

• Ensure the utilization review activities are completed accurately and timely.
• Complete precertification and recertification.
• Complete peer to peer process and appeals.
• Report consistently and accurately to the CEO or delegate the authorization status of current patients and appeals.
• Ensure that all UR staff members follow department and facility procedures.
• Ensure that communication with all relevant departments, but especially CBO and Business Office, meets staff and patient needs.

Benefits

• Comprehensive Benefits: Multiple levels of medical, dental and vision coverage for full-time and part-time employees.
• Financial Protection & PTO: Life, accident, critical illness, hospital indemnity insurance, short- and long-term disability, paid family leave and paid time off.
• Financial & Career Growth: Higher education and certification tuition assistance, loan assistance and 401(k) retirement package and company match.
• Employee Well-being: Mental, physical, and financial wellness programs (free gym memberships, virtual care appointments, mental health services and discount programs).
• Professional Development: Ongoing learning and career advancement opportunities.

What This Job Offers

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