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Hybrid Utilization Review Manager na Harbor Oaks Hospital

Harbor Oaks Hospital · New Baltimore, Estados Unidos Da América · Hybrid

$52,000.00  -  $72,800.00

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Overview:

Harbor Oaks Hospital is looking for a Utilization Review Manager to join our team!

 

Harbor Oaks Hospital, New Baltimore's leading Mental Health and Addiction Treatment Center is seeking a passionate Utilization Review Manager to work at our facility in New Baltimore, MI. 

 

Non-Exempt Position

PRN Position

Monday - Friday - Day Shift 

 

Rate of Pay: $25.00 - $35.00 per hour (based on experience)

 

 

 

 

Responsibilities:

PURPOSE STATEMENT:

Monitor utilization of services and optimize reimbursement for the facility while maximizing use of the patient’s provider benefits for their needs. 

 

ESSENTIAL FUNCTIONS:

  • Provide consultation and guidance regarding admissions and patient length of stay to a variety of payers.
  • Secure authorizations with insurance companies for inpatient treatment and continue to obtain authorizations for duration of patient stay.
  • Evaluate the utilization program for compliance with regulations, policies and procedures.
  • Review clinical documentation from denied stays against criteria to determine if documentation is adequate for requested treatment.
  • Provide staff management to including hiring, development, training, performance management and communication to ensure effective and efficient department operation.

OTHER FUNCTIONS:

  • Perform other functions and tasks as assigned.
Qualifications:

LICENSES/DESIGNATIONS/CERTIFICATIONS:

  • If applicable, current licensure as an LPN or RN or LPC, or LMSW or LLMSW within the state where the facility provides services; or current clinical professional license or certification, as required, within the state where the facility provides services.
  • CPR and de-escalation and restraint certification required (training available upon hire and offered by facility).
  • First aid may be required based on state or facility requirements.

 

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