Utilization Review Manager- PRN

Harbor Oaks Hospital • New Baltimore, MI

5d • $25 - $35 • Onsite

About The Position

Harbor Oaks Hospital is seeking a Utilization Review Manager for its mental health and addiction treatment facility in New Baltimore, Michigan. The role monitors utilization of services and optimizes facility reimbursement while maximizing use of patients’ provider benefits. This is a non-exempt, PRN position scheduled Monday through Friday on the day shift, with pay of $25.00–$35.00 per hour based on experience.

Requirements

• If applicable, hold a current LPN, RN, LPC, LMSW, or LLMSW license in the state where the facility provides services, or hold another current clinical professional license or certification required in that state.
• CPR certification is required.
• De-escalation and restraint certification is required; training is available upon hire and offered by the facility.
• First aid may be required depending on state or facility requirements.

Responsibilities

• Provide consultation and guidance to a variety of payers regarding admissions and patient length of stay.
• Secure insurance authorizations for inpatient treatment and continue obtaining authorizations throughout the patient’s stay.
• Evaluate the utilization program for compliance with regulations, policies, and procedures.
• Review clinical documentation for denied stays against criteria to determine whether documentation supports the requested treatment.
• Manage staff, including hiring, development, training, performance management, and communication, to support effective and efficient department operations.
• Perform other functions and tasks as assigned.

What This Job Offers

• Career Level: Manager
• Education Level: No Education Listed