Utilization Review Manager

UHS•Grand Rapids, MI

37d

About The Position

The Utilization Manager is responsible for directing and overseeing the Utilization Program for Inpatient and Outpatient services. This includes the implementation of case management scenarios, consulting with all services to ensure the provision of an effective treatment plan for all patients, oversees the response to requests for services and interfaces with managed care organizations, external reviewers, and other payors.

Requirements

Bachelor's Degree required.
A minimum of three years’ experience in Utilization Management Required.
State of Michigan licensure as LLP, LPC, LLPC LMSW, LLMSW, or Registered Nurse RN.

Responsibilities

Directing and overseeing the Utilization Program for Inpatient and Outpatient services
Implementation of case management scenarios
Consulting with all services to ensure the provision of an effective treatment plan for all patients
Overseeing the response to requests for services
Interfaces with managed care organizations, external reviewers, and other payors

Benefits

Excellent Medical, Dental, Vision and Prescription Drug Plans
Student Loan Repayment Program
401(k) and Roth 401(k) with Company Match
Employee Stock Purchase Program
Competitive Compensation & Paid Time Off
Disability, Life, Pet Insurance and much more!
Career ladder focus with opportunities to cross train, build skills and grow in leadership
Tuition reimbursement assistance program
Tuition savings through a partnership with Chamberlain University
In-house Psychiatric Nurse Residency Transition-to-Practice Orientation (20 CEUs)
Career development opportunities across UHS and our 300+ locations!
HealthStream online learning catalogue with plenty of free CEU courses