Utilization Review Director

Freedom Behavioral; Lake Charles (LA); On-site; USD 80,000 - 100,000; Full time

Benefits offered by this job

Challenging and rewarding work environment

Excellent staff-to-patient ratio

Competitive compensation

Medical, Dental, Vision, and Prescription Drug Plan

Generous paid time off

401(k) with company match

Job summary

Freedom Behavioral in Lake Charles, Louisiana, is seeking a Utilization Review Director responsible for overseeing utilization review and discharge planning processes, ensuring compliance with regulations.

The ideal candidate will have a degree in social science or nursing and at least one year of relevant experience. Benefits include competitive compensation, medical, dental, vision plans, and 401(k) with company match.

Qualifications

• Minimum 1 year coordinating utilization review and discharge planning activities.

Responsibilities

• Oversee utilization review and discharge planning processes.
• Collaborate with admissions, medical providers, and clinical staff.
• Review patient records to evaluate medical necessity.
• Manage precertification and continued stay authorizations.
• Act as primary point of contact for payors.
• Support discharge planning efforts.
• Maintain performance improvement initiatives.

Education

Degree in a social science or nursing education

Job description

NOTE: This position is currently filled. However, Freedom Behavioral may take future applications if a vacancy occurs.

Position Summary

A Utilization Review (UR) Director at Freedom Behavioral Hospital is responsible for overseeing utilization review and discharge planning processes in compliance with CMS, federal, and state regulations, as well as the organization’s policies and performance improvement standards.

Responsibilities

• Oversee utilization review and discharge planning processes
• Collaborate with admissions, medical providers, and clinical staff to ensure appropriate, medically necessary care
• Review patient records to evaluate medical necessity of admissions, treatment plans, and length of stay
• Manage precertification and continued stay authorizations
• Act as the primary point of contact for payors
• Communicate admission and continued stay criteria with referral sources, families, insurance representatives, and interdisciplinary teams
• Refer cases requiring additional clinical expertise to the Medical Director
• Facilitate treatment team processes and support discharge planning efforts
• Promote effective communication among departments
• Maintain performance improvement initiatives and participate in quality management activities

Qualifications

• Education: A degree in a social science or nursing education preferred
• Experience: Minimum 1 year coordinating utilization review and discharge planning activities

Benefits

• Challenging and rewarding work environment
• Excellent staff-to-patient ratio
• Competitive compensation
• Medical, Dental, Vision, and Prescription Drug Plan
• Generous paid time off
• 401(k) with company match

Freedom provides equal employment opportunities to all employees and applicants for employment and prohibits discrimination and harassment of any type without regard to race, color, religion, age, sex, national origin, disability status, genetics, protected veteran status, sexual orientation, gender identity, or any other characteristic protected by federal, state, or local laws. This policy applies to all terms and conditions of employment, including recruiting, hiring, placement, promotion, termination, layoff, recall, transfer, leaves of absence, compensation, and training.

All applicants selected for employment will be required to undergo a post‑offer drug test and federal background investigation.