Director of Utilization Review – Mental Health

Lighthouse Care Center of Augusta; Augusta (GA); On-site; USD 110,000 - 150,000; Full time

Benefits offered by this job

Referral Bonus Program

Competitive Compensation

Generous PTO

Excellent Medical/Dental/Vision

401(k) with company match

Career development opportunities

Job summary

Lighthouse Care Center of Augusta in Augusta, GA seeks a dedicated Director of Utilization Review to lead our case management team in delivering high-quality and cost-effective psychiatric care.

The role oversees Utilization Review coordinators, collaborates with physicians, therapists, and nursing staff, and ensures timely precertifications and continued authorizations with insurance providers, while aligning with government regulations and accreditation standards.

Qualifications

• 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

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)

Education

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

Experience including one year of managing a related function preferred

Job description

Lighthouse Care Center of Augusta in Augusta, GA seeks a dedicated Director of Utilization Review to lead our case management team in delivering high-quality and cost-effective psychiatric care.

The role oversees Utilization Review coordinators, collaborates with physicians, therapists, and nursing staff, and ensures timely precertifications and continued authorizations with insurance providers, while aligning with government regulations and accreditation standards.