Director of Utilization Review & Care Coordination

Universal Health Services, Inc.; Augusta (GA); On-site; USD 110,000 - 140,000; Full time

Benefits offered by this job

Referral Bonus

Paid Time Off

Health/Dental/Vision

401(k) with match

Career development

Job summary

Lighthouse Care Center of Augusta is seeking a dedicated Director of Utilization Review to join our growing team. This role focuses on collecting, analyzing and presenting clinical data to insurance providers to obtain authorizations and align with Universal Health Services' mission and regulatory standards.

The Director will integrate with the Lighthouse Case Management Team, coordinating with treatment services to ensure high-quality, cost-effective care for patients with mental illness and

Qualifications

• Masters Degree in nursing, social work, mental health counseling, or related field.
• Five years direct clinical psychiatric/mental health experience.
• Experience in patient assessment, treatment planning, and external review communications.
• Management experience in related function preferred.

Responsibilities

• Oversee Utilization Review coordinators as working manager.
• Participate in treatment team meetings with physicians, therapists, nurses and staff.
• Authorize initial precertifications and continued authorizations.
• Ensure timely gathering and entry of clinical criteria in systems (Midas).

Skills

UR leadership

Team coordination

Leadership

Collaboration

Education

RN/APRN/LCSW/LMSW licensure

Job description

Lighthouse Care Center of Augusta is seeking a dedicated Director of Utilization Review to join our growing team. This role focuses on collecting, analyzing and presenting clinical data to insurance providers to obtain authorizations and align with Universal Health Services' mission and regulatory standards.

The Director will integrate with the Lighthouse Case Management Team, coordinating with treatment services to ensure high-quality, cost-effective care for patients with mental illness and