Director of Utilization Review - Behavioral Health

Behavioral Health System, Inc.; Memphis (TN); On-site; USD 110,000 - 160,000; Full time

Benefits offered by this job

Challenging and rewarding work env.

Career development opportunities

Competitive compensation & generous PT

Excellent medical, dental, vision & Rx

401k with company match

SoFi student loan refinancing

Tuition savings for nursing education

Pet insurance

Job summary

Lakeside Behavioral Health System is seeking a seasoned healthcare leader to oversee utilization management, case documentation, payer relationships, regulatory requirements, and department administration. This role drives hospital performance, patient satisfaction, and compliant reimbursement.

Qualifications include a Masters in a health-related field, 8–10 years in acute inpatient psychiatry or 5–7 years in utilization management, and preferred TN licensure (RN/LCSW/LPC).

Qualifications

• Masters prepared healthcare leader/director in Nursing, Counseling, Psychology or Social Work.
• 8-10 years in an acute inpatient psychiatric setting as a treatment team member, or 5-7 years in utilization management for mental health/substance abuse behavioral health disorders.
• Valid TN RN license, LCSW, or LPC preferred.
• Knowledge of managed care payer practices, DSM-V codes, and data-driven trend analysis; ability to drive compliance and performance.

Responsibilities

• Oversees utilization management including utilization review, case documentation, payer relationships, regulatory requirements, staff management and department administration.
• Supports the hospital's success, patient satisfaction, regulatory compliance and optimal reimbursement.

Skills

Communication skills

Team leadership

Regulatory compliance

Education

Masters prepared healthcare leader/director (Nursing, Counseling, Psychology or Social Work)

Job description

Lakeside Behavioral Health System is seeking a seasoned healthcare leader to oversee utilization management, case documentation, payer relationships, regulatory requirements, and department administration. This role drives hospital performance, patient satisfaction, and compliant reimbursement.

Qualifications include a Masters in a health-related field, 8–10 years in acute inpatient psychiatry or 5–7 years in utilization management, and preferred TN licensure (RN/LCSW/LPC).