Director of Utilization Review & Care Coordination

Lighthouse-Care-Center-of-August; Westwood (GA); On-site; USD 100,000 - 150,000; Full time

Benefits offered by this job

Referral bonus

Challenging environment

Generous PTO

Medical, dental, vision plans

401(k) with company match

Career development

Job summary

Lighthouse Care Center of Augusta seeks a dedicated Director of Utilization Review to lead the UR team and ensure efficient, compliant authorizations for psychiatric care. This role integrates clinical data with insurance requirements to support high-quality, cost-effective treatment.

The candidate will oversee UR coordinators, coordinate with physicians and therapists, and manage pre-certifications while ensuring accurate data entry and reporting to payers.

Qualifications

• Master's degree in nursing or related field.
• 5+ years psychiatric/mental health clinical experience.
• Experience in case management or utilization review preferred.
• Licensure as RN/APRN/APC/LPC/LMSW/LCSW preferred.

Responsibilities

• Oversee Utilization Review coordinators.
• Coordinate with treatment team and physicians.
• Obtain pre-certifications and authorizations.
• Ensure data collection and reporting to insurers.

Skills

Leadership

Clinical assessment

Communication

Team collaboration

Education

Master's degree in nursing or related field

Tools

Midas

Job description

Lighthouse Care Center of Augusta seeks a dedicated Director of Utilization Review to lead the UR team and ensure efficient, compliant authorizations for psychiatric care. This role integrates clinical data with insurance requirements to support high-quality, cost-effective treatment.

The candidate will oversee UR coordinators, coordinate with physicians and therapists, and manage pre-certifications while ensuring accurate data entry and reporting to payers.