Behavioral Health Utilization Manager — Lead & Improve Care

Nhccare; Murfreesboro (TN); Sur place; USD 100 000 - 140 000; Plein temps

Résumé du poste

National HealthCare Corporation seeks an experienced Manager of Utilization Management to lead utilization review across our behavioral health hospitals. You will oversee authorizations, concurrent reviews, denial management, payer relationships, and a team of utilization management staff to ensure patients receive appropriate levels of care promptly.

The ideal candidate has 6+ years in behavioral health and utilization management, with leadership experience and strong knowledge of

Qualifications

• Bachelor's degree in Nursing or related clinical field.
• 6+ years of clinical experience, preferably in behavioral health.
• 3+ years of leadership experience.

Responsabilités

• Lead and support a team of utilization management professionals.
• Oversee authorization, concurrent review, continued stay review, and denial management activities.
• Partner with physicians, nursing, case management, and revenue cycle teams to support appropriate level-of-care decisions.
• Monitor payer requirements, medical necessity criteria, and regulatory compliance.
• Analyze performance metrics and implement process improvements that support quality outcomes and financial performance.
• Assist with appeals, denial prevention strategies, and operational best practices across facilities.

Connaissances

Leadership

Communication

Analytical

Team leadership

Formation

Bachelor's degree in Nursing or related clinical field

Description du poste

National HealthCare Corporation seeks an experienced Manager of Utilization Management to lead utilization review across our behavioral health hospitals. You will oversee authorizations, concurrent reviews, denial management, payer relationships, and a team of utilization management staff to ensure patients receive appropriate levels of care promptly.

The ideal candidate has 6+ years in behavioral health and utilization management, with leadership experience and strong knowledge of