UTILIZATION REVIEW MANAGER
About The Position
Gulfport Behavioral Health System, is a 92-bed psychiatric hospital offering child, adolescent, adult and military service behavioral health programs and treatment services. For more information, please visit us at www.gulfportbehavioral.com/ Position Summary: Utilization Review Manager assumes responsibility for the functioning of the Utilization Review Department. Provides utilization review services in a manner consistent with the philosophy and objectives of the facility; 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 Master’s Degree in human services field preferred.
- Minimum of 2 years clinical experience and 1 year of management experience with case management and the utilization review process including concurrent reviews.
- Current license in the state of Missisippi, including RN, LMSW, LMFT, LPC
Nice To Haves
- Previous continuum of care experience highly preferred.
Responsibilities
- Functioning of the Utilization Review Department
- Provides utilization review services
- 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
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
- Free Basic Life Insurance
- Tuition Reimbursement
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What This Job Offers
Job Type
Full-time
Career Level
Manager
Number of Employees
1,001-5,000 employees
