Utilization Management Supervisor - Behavioral Health

Texoma Medical Center; Orlando (FL); Presencial; USD 70 000 - 90 000; Tempo integral

Vantagens oferecidas por esta oferta de emprego

Competitive compensation

Generous paid time off

Excellent medical, dental, vision and药

401(k) with company match

SoFi student loan refinancing

Tuition savings with Chamberlain

Career development opportunities

Pet insurance

Resumo da oferta

Central Florida Behavioral Hospital in Orlando, FL is seeking a UM Supervisor who reports to the Director of Utilization Management. The role provides oversight for UR staff and ensures compliance with medical necessity and regulatory standards.

The position emphasizes reviewing patient records, managing denial letters, and maintaining adherence to Joint Commission, CMS, EMTALA, HIPAA, and related guidelines within a private psychiatric setting.

Qualificações

• Master’s degree in social work or mental health field or equivalent for licensure.
• Two years of experience with external review organizations in chart analysis and UR.
• Ability to work independently and set priorities.
• Valid FL license: RN, LCSW, LMHC, LMFT preferred.

Responsabilidades

• Ensure protocol for clinicians to review the patient’s medical records on specific days to meet continued authorization.
• Ensure staff knowledge regarding medical necessity, regulatory requirements and standards (Joint Commission, Title 9, CMS/Medicare, EMTALA, HIPAA).
• Oversee UR activities, including written appeal letters for denials.

Conhecimentos

Independent work

Communication with external review org

Formação académica

Master’s degree in social work or mental health field

Descrição da oferta de emprego

Central Florida Behavioral Hospital in Orlando, FL is seeking a UM Supervisor who reports to the Director of Utilization Management. The role provides oversight for UR staff and ensures compliance with medical necessity and regulatory standards.

The position emphasizes reviewing patient records, managing denial letters, and maintaining adherence to Joint Commission, CMS, EMTALA, HIPAA, and related guidelines within a private psychiatric setting.