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Utilization Review Manager

Utilization Review Manager

Acadia HealthcareNew Baltimore, MI, US
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Utilization Review Manager

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)

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 including hiring, development, training, performance management and communication to ensure effective and efficient department operation.

Other Functions :

  • Perform other functions and tasks as assigned.

    • 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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    Manager Utilization Review • New Baltimore, MI, US

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