Utilization Management Supervisor — Impact & Growth

Central Florida Behavioral Hospital; Orlando, Northern (FL, KY); Híbrido; USD 70 000 - 90 000; Tempo integral

Vantagens oferecidas por esta oferta de emprego

Medical plans

401(k) with match

Dental plan

Vision plan

Prescription drug coverage

Paid time off

Student loan refinancing

Resumo da oferta

Central Florida Behavioral Hospital in Orlando, FL, 174-bed private psychiatric center, seeks an UM Supervisor to oversee the Utilization Management department and ensure high-quality care. The role involves directing UR activities, monitoring medical record reviews, and maintaining compliance with regulatory standards, including Joint Commission and CMS guidelines.

Under the direction of the Director, Utilization Management, you will lead staff, optimize workflows, and support accurate medical

Qualificações

• Master’s degree required from an accredited college or university in social work, mental health related field or equivalent for licensure.
• A minimum of two (2) years' experience with communication with external review organizations in chart analysis and UR field required.
• Ability to work independently and set priorities.
• Valid FL license: RN, LSCW, LMHC, LMFT preferred.

Responsabilidades

• Ensure protocol for clinicians to review the patient’s medical record on specific days to meet continued authorization.
• Ensure knowledge of staff regarding medical necessity, regulatory requirements and standards, i.e. Joint Commission, Title 9, CMS/Medicare guidelines, EMTALA, HIPAA, etc.
• Oversee processes and procedures for all UR activities, including written appeal letters for denials

Conhecimentos

Regulatory knowledge

External review coordination

Independent work

Leadership

Formação académica

Master's degree in social work or related field

Descrição da oferta de emprego

Central Florida Behavioral Hospital in Orlando, FL, 174-bed private psychiatric center, seeks an UM Supervisor to oversee the Utilization Management department and ensure high-quality care. The role involves directing UR activities, monitoring medical record reviews, and maintaining compliance with regulatory standards, including Joint Commission and CMS guidelines.

Under the direction of the Director, Utilization Management, you will lead staff, optimize workflows, and support accurate medical