Manager, Utilization Management (RN) - Texas Behavioral Health Center

UT Southwestern Medical Center; Dallas (TX); On-site; USD 110,000 - 140,000; Full time

Benefits offered by this job

PPO medical plan

Paid Time Off

Retirement Programs

Paid Parental Leave

Job summary

The RN Manager, Behavioral Health Utilization Management at UT Southwestern Medical Center in Dallas leads the Behavioral Health UM team, develops policies, ensures compliance with standards, and oversees admissions, treatment and continued stay for behavioral health patients.

The role requires RN license, 6 years nursing with 3 years UM, strong negotiation and analytical skills, and experience in psychiatric or substance use care; benefits include comprehensive coverages and retirement programs.

Qualifications

• 5 years in a healthcare management or utilization management position.
• 6 years nursing experience with three (3) years UM experience
• Experience in behavioral health utilization management, including psychiatric and/or substance use disorder levels of care
• 1 year of experience implementing utilization management policies for mental health services
• 1 year of experience supervising mental health providers or UM staff
• Proven record of identifying process improvement opportunities

Responsibilities

• Ensure concurrent and retrospective reviews are performed using evidence-based standards.
• Provide leadership guidance to the Behavioral Health Utilization Management team.
• Develop policies and procedures ensuring governmental and accrediting standards compliance.

Skills

Negotiation

Analytical skills

Organizational skills

Process improvement

Education

Bachelor's Degree BA/BS

Job description

Texas Behavioral Health Center

The Texas Behavioral Health Center is a newly completed state-funded psychiatric hospital opening in Dallas' Southwestern Medical District that is owned by the Texas Health and Human Services Commission (HHSC) and operated by UT Southwestern Medical Center.

When fully operational, the 505,000-square-foot facility will house 292 beds - 200 for adult patients and 92 for children and adolescents. As DFW's first state-funded behavioral health hospital, it is designed to deliver state-of-the-art, patient-centered care in a modern and healing environment. The center provides comprehensive behavioral health treatment and features private patient rooms, abundant access to natural light and nature, and thoughtfully designed spaces that promote recovery. The hospital will also provide training to all behavioral health disciplines.

As employees of UT Southwestern, team members will join a world-class academic medical center committed to patient-centered care, innovation, interdisciplinary collaboration, and preparing patients for successful reintegration into their families and communities. With competitive benefits and a mission-driven culture, Texas Behavioral Health Center offers an unparalleled opportunity to make a lasting impact on mental health care in North Texas. Learn more about Texas Behavioral Health Center here!

WHY UT SOUTHWESTERN?

With over 75 years of excellence in Dallas-Fort Worth, Texas, UT Southwestern is committed to excellence, innovation, teamwork, and compassion. As a world-renowned medical and research center, we strive to provide the best possible care, resources, and benefits for our valued employees. Ranked as the No. 1 hospital in Dallas-Fort Worth according to U.S. News & World Report , we invest in you with opportunities for career growth and development to align with your future goals. Our highly competitive benefits package offers healthcare, PTO and paid holidays, on-site childcare, wage, merit increases and so much more. We invite you to be a part of the UT Southwestern team where you'll discover a culture of teamwork, professionalism, and a rewarding career!

JOB SUMMARY

The RN Manager, Behavioral Health Utilization Management works under minimal supervision to provide leadership guidance to the Behavioral Health Utilization Management team by planning, organizing and supervising the activities of the staff. Develops policies and procedures for adherence to governmental and accrediting agency standards governing admissions, treatment and continued stay of behavioral health patients, including psychiatric and substance use disorder levels of care.

BENEFITS

• PPO medical plan, available day one at no cost for full-time employee-only coverage
• 100% coverage for preventive healthcare-no copay
• Paid Time Off, available day one
• Retirement Programs through the Teacher Retirement System of Texas (TRS)
• Paid Parental Leave Benefit
• Wellness programs
• Tuition Reimbursement
• Public Service Loan Forgiveness (PSLF) Qualified Employer

Learn more about these and other UTSW employee benefits!

EXPERIENCE AND EDUCATION

Required

• 5 years in a healthcare management or utilization management position
• 6 years nursing experience with three (3) years UM experience and
• Experience in behavioral health utilization management, including psychiatric and/or substance use disorder levels of care, medical necessity review, payer authorization processes, and continued stay review and
• 1 year of experience implementing utilization management policies, procedures and protocols for mental health services, either as a provider or manager and
• 1 year of experience supervising mental health providers or behavioral health utilization management staff and
• Proven record of identifying process improvement opportunities and
• Requires strong negotiating, analytical and organizational skills as well as the ability to be flexible with changing needs and deadlines; the ability to interact and communicate both verbally and in writing with all levels of associates, management and patients

Licenses and Certifications

(RN) REGISTERED NURSE Current Texas Registered Nurse license is required.

Preferred

• Bachelor's Degree BA/BS degree
• Acute inpatient behavioral health experience is strongly preferred
• Knowledge of the healthcare revenue cycle, including insurance processes

JOB DUTIES

Ensures that behavioral health inpatient concurrent reviews and retrospective review requests are performed using nationally recognized and evidence based standards, including applicable psychiatric and substance use disorder criteria. Ensures quality of documentation and actively participates in managing behavioral health utilization across the Continuum of Care to full efficiency. Provides leadership guidance to the U