Director of Utilization Review
ABOUT HIGHLAND RIDGE HOSPITAL We provide inpatient treatment in the heart of Salt Lake Valley to people experiencing psychiatric and chemical dependency crises.
Lately there has been an alarming increase in depression anxiety and substance abuse among our friends and neighbors.
As the demand for mental health and chemical dependency services increases across the country we are expanding to meet the needs of our fellow Utahans.
We are looking for passionate patient advocates like youCome grow with us JOB SUMMARYDirect and manage the daytoday operations of the Utilization Review department.
ESSENTIAL FUNCTIONS Monitor utilization of services and optimize reimbursement for the facility while maximizing use of thepatients provider benefits for their needs.
Conduct and oversee concurrent and retrospective reviews for all patients.
Act as a liaison between Medicaid reviewers and the staff completing required paperwork to facilitatethe Utilization Review process.
Collaborates with physicians therapist and nursing staff to provide optimal review andto prevent delays in services.
Evaluates the UM program for compliance with regulations policies and procedures.
May review charts and make necessary recommendations to the physicians regarding utilizationreview and specific managed care issues.
Provide staff management to including hiring development training performance management andcommunication to ensure effective and efficient department operation.
EDUCATIONEXPERIENCESKILL REQUIREMENTS Bachelors Degree in nursing or other clinical field required.
Masters Degree in clinical field preferred.
Six or more years clinical experience with the behavioral health population preferred.
Four or more years experience in utilization management required.
Three or more years of supervisory experience required.
AVAILABLE BENEFITS Medical Dental Vision Life Insurance Disability k and Paid Time Off.
.
Estimated Salary: $20 to $28 per hour based on qualifications.
Lately there has been an alarming increase in depression anxiety and substance abuse among our friends and neighbors.
As the demand for mental health and chemical dependency services increases across the country we are expanding to meet the needs of our fellow Utahans.
We are looking for passionate patient advocates like youCome grow with us JOB SUMMARYDirect and manage the daytoday operations of the Utilization Review department.
ESSENTIAL FUNCTIONS Monitor utilization of services and optimize reimbursement for the facility while maximizing use of thepatients provider benefits for their needs.
Conduct and oversee concurrent and retrospective reviews for all patients.
Act as a liaison between Medicaid reviewers and the staff completing required paperwork to facilitatethe Utilization Review process.
Collaborates with physicians therapist and nursing staff to provide optimal review andto prevent delays in services.
Evaluates the UM program for compliance with regulations policies and procedures.
May review charts and make necessary recommendations to the physicians regarding utilizationreview and specific managed care issues.
Provide staff management to including hiring development training performance management andcommunication to ensure effective and efficient department operation.
EDUCATIONEXPERIENCESKILL REQUIREMENTS Bachelors Degree in nursing or other clinical field required.
Masters Degree in clinical field preferred.
Six or more years clinical experience with the behavioral health population preferred.
Four or more years experience in utilization management required.
Three or more years of supervisory experience required.
AVAILABLE BENEFITS Medical Dental Vision Life Insurance Disability k and Paid Time Off.
.
Estimated Salary: $20 to $28 per hour based on qualifications.
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