Manager - Utilization Review

Behavioral Health System, Inc.; Memphis (TN); On-site; USD 120,000 - 170,000; Full time

Benefits offered by this job

Competitive compensation

Generous paid time off

Medical, dental, vision plans

401k with company match

SoFi student loan refinancing program

Tuition assistance

Job summary

Lakeside Behavioral Health System seeks a leaders in utilization management to oversee utilization review, documentation, payer relations, regulatory compliance, and department administration. This role supports the hospital’s success and patient satisfaction while ensuring compliant reimbursement.

Qualified candidates bring Masters-level leadership experience in healthcare, with clinical background in acute psychiatric settings and knowledge of case management and crisis response.

Qualifications

• Masters prepared healthcare leader/director.
• Minimum 5–8 years clinical experience in acute psychiatric setting as a treatment team member or 3–5 years in utilization management.
• RN licensure if RN appears to be required.
• Knowledge of case management, growth and development, crisis and behavior management.

Responsibilities

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

Skills

Clinical leadership

Utilization management

Case documentation

Payer relationships

Regulatory compliance

Education

Masters degree in healthcare leadership/director

Job description

Responsibilities

Lakeside Behavioral Health System provides an excellent opportunity for those seeking to be part of a team-oriented and compassionate organization. Our staff tell us that our team is their number one reason for working at Lakeside and we offer competitive compensation, excellent comprehensive benefits, opportunities for advancement, tuition assistance, and paid time off.

Since 1969, Lakeside has been the premier provider of specialized behavioral health and addictive disease services in the Memphis and Mid-South region. The 365-bed facility is one of the largest free-standing psychiatric hospitals in the United States. We are located on a serene 37-acre campus in northeast Shelby County, serving as the setting for the treatment for children, adolescents, young adults, adults and seniors. Lakeside’s comprehensive programs treat disorders such as bipolar disorder, psychological trauma, depression and anxiety, mental illness and addictive disease disorders such as alcoholism, drug addiction and substance abuse.

Job Description

Oversees utilization management including, but not limited to: utilization review, case documentation, payer relationships, regulatory requirements, staff management and department administration. Supports the overall success of the hospital and promotes patient satisfaction, regulatory compliance and optimal reimbursement.

This opportunity provides the following:

• Challenging and rewarding work environment
• Career development opportunities within UHS and its 300+ subsidiaries
• Competitive Compensation & Generous Paid Time Off
• Excellent Medical, Dental, Vision and Prescription Drug Plans
• 401k with company match and discounted stock plan
• SoFi Student Loan Refinancing Program
• Tuition savings to continue your nursing education with Chamberlain University
• Pet Insurance
• More information is available on our Benefits Guest Website: benefits.uhsguest.com.

About Universal Health Services (UHS)

Headquartered in King of Prussia, PA, Universal Health Services, Inc. (NYSE: UHS) is one of the nation’s largest and most respected providers of hospital and healthcare services. Since our founding in 1979, UHS has grown steadily into a premier Fortune 500® corporation perennially recognized by multiple esteemed national rating entities. Through its subsidiaries, UHS operates inpatient acute care facilities, inpatient behavioral health facilities, outpatient and other facilities, nationwide virtual behavioral health services, an insurance offering, a physician network and various related services with physical locations in the U.S., Puerto Rico, Ireland and United Kingdom. www.uhs.com.

Qualifications

Job Requirements

Education: Masters prepared healthcare leader/director. Masters degree in Nursing, Counseling, Psychology or Social Work required.

Experience: Minimum of 5-8 years clinical experience with acute psychiatric setting as a treatment team member or 3-5 years in utilization management experience with case management and the utilization management process including concurrent reviews. Previous continuum of care experience highly preferred.

Licensure/Certification: If RN – licensure required.

Knowledge: Prefer knowledge of case management, age specific growth and development, crisis, and behavior management.

EEO Statement

All UHS subsidiaries are committed to providing an environment of mutual respect where equal employment opportunities are available to all applicants and teammates. UHS subsidiaries are equal opportunity employers and as such, openly support and fully commit to recruitment, selection, placement, promotion and compensation of individuals without regard to race, color, religion, age, sex (including pregnancy, gender identity, and sexual orientation), genetic information, national origin, disability status, protected veteran status or any other characteristic protected by federal, state or local laws.