DIR - UTILIZATION REVIEW / MGMT

Talentify; Augusta (GA); On-site; USD 90,000 - 120,000; Full time

Benefits offered by this job

Referral Bonus

Comprehensive Benefits

401K with match

Generous PTO

Medical/Dental/Vision

Career development

Job summary

Lighthouse Care Center of Augusta seeks a dedicated Director of Utilization Review to lead the Utilization Review team within its Case Management structure. The role focuses on coordinating a patient-centric therapeutic strategy while ensuring high-quality, cost-effective treatment aligned with UHS standards.

The position requires strong clinical data analysis, collaboration with medical staff, and expertise in negotiating authorizations with insurers to support treatment services.

Qualifications

• Masters level clinical leadership experience in psychiatric/mental health setting.
• Experience communicating with external review organizations or similar entities.

Responsibilities

• Oversee Utilization Review coordinators as a working manager
• Participate in treatment team meetings with physicians, therapists, nurses and staff
• Authorize initial precertifications and ongoing authorizations with payers
• Ensure timely gathering and entry of clinical criteria into Midas and related systems

Skills

Leadership

Clinical experience

Healthcare administration

Education

Master's degree in nursing, social work, mental health counseling, or related field

Tools

Midas

Job description

Responsibilities

Lighthouse Care Center of Augusta is seeking a dedicated, compassionate Director of Utilization Review to add to our growing team.

Lighthouse Care Center of Augusta has been providing psychiatric services to the CSRA for more than 15-years. Located in Augusta, GA our 84-bed facility provides a therapeutic setting for those seeking treatment for mental illness. Lighthouse Care Center offers unique and individualized programming for adolescents and adults that sets us apart from many other treatment facilities, and our tenured team includes seasoned medical staff.

Website: https://www.LighthouseCareCenters.com

The Director of Utilization Review is a key member of the Lighthouse Case Management Team who will integrate and coordinate a patient centric therapeutic strategy with a keen focus on clinical content; ensuring that delivery of high-quality and cost-effective treatment is consistent with the mission, vision, and values of Universal Health Services and in accordance with government regulation, licensing and accreditation requirements. The Director of Utilization Review is responsible for the collection, analysis and articulation of required clinical data to insurance providers to obtain authorizations and ensure coordination with treatment services. The population served are patients' whose lives are disrupted or complicated by mental illness, behavioral disturbance, substance issues or inability to function or maintain in the community.

Job Duties/Responsibilities

• Working manager who oversees the Utilization Review coordinators
• Participate in treatment team meetings, collaborate with physicians, therapist, nurses and pertinent staff
• Authorizing entities to ensure initial precertification and continued authorization is achieved
• Responsible for aspects relative to timely gathering clinical criteria, communication of clinical criteria, and entry of supporting clinical criteria into computer based systems (Midas)

Benefit Highlights

• Referral Bonus Program
• Challenging and rewarding work environment
• Competitive Compensation & Generous Paid Time Off
• Excellent Medical, Dental, Vision and Prescription Drug Plans
• 401(K) with company match and discounted stock plan
• Career development opportunities within UHS and its 300+ Subsidiaries!
• More information is available on our Benefits Guest Website: uhsguest.com

About Universal Health Services

One of the nation’s largest and most respected providers of hospital and healthcare services, Universal Health Services, Inc. (UHS) has built an impressive record of achievement and performance. Growing steadily since its inception into an esteemed Fortune 500 corporation, annual revenues during 2025 were $17.4 billion. In 2026, UHS was again recognized as one of Fortune World’s Most Admired Companies and in 2025, was listed in Forbes ranking of America’s Largest Public Companies. Headquartered in King of Prussia, PA, UHS has approximately 101,500 employees and continues to grow through its subsidiaries. Operating acute care hospitals, behavioral health facilities, outpatient facilities and ambulatory care access points, an insurance offering, a physician network and various related services located in 40 U.S. states, Washington, D.C., Puerto Rico and the United Kingdom. For additional information visit www.uhs.com.

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Qualifications

Education and Experience

• Masters Degree in nursing, social work, mental health counseling, or related field
• Minimum of five (5) years direct clinical experience in a psychiatric or mental health treatment setting
• Including one year of managing a related function preferred
• Experience in patient assessment, treatment planning and communication with external review organizations or comparable entities

Certifications, License, Registration

Required with licensure, APRN, LPC, LMSW, LCSW, RN preferred

EEO Statement

All UHS subsidiaries are committed to providing an environment of mutual respect where equal employment opportunities are available to all applicants and teammates. UHS subsidiaries are equal opportunity employers and as such, openly support and fully commit to recruitment, selection, placement, promotion and compensation of individuals without regard to race, color, religion, age, sex (including pregnancy, gender identity, and sexual orientation), genetic information, national origin, disability status, protected veteran status or any other characteristic protected by federal, state or local laws.