Utilization Review Director: Lead Care & Reimbursement

Universal Health Services; Gulfport (MS); Hybrid; USD 90,000 - 130,000; Full time

Benefits offered by this job

Sign-on bonus $5,000

Medical, Dental, Vision plan

401(K) with company match

Generous PTO

Tuition Reimbursement

Free Basic Life Insurance

Career development opportunities

Job summary

Gulfport Behavioral Health System, an acute behavioral health hospital on the Mississippi Gulf Coast, seeks a Director of Utilization Review to lead the department and ensure appropriate use of services. The role evaluates medical records for illness severity and care level, and serves as liaison with insurance providers to advocate for patients.

The position offers a $5,000 sign-on bonus and opportunities for career development within UHS and its subsidiaries, with a comprehensive benefits

Qualifications

• Education: Bachelor degree in Nursing or Master’s in human services preferred.
• Experience: 2+ years clinical experience and 1+ year in management with case management and utilization review.
• Licensure: Current Mississippi license (RN, LMSW, LMFT, or LPC).

Responsibilities

• Oversee and direct the Utilization Review Department functioning.
• Evaluate patient records to determine illness severity and level of care.
• Liaise with patients, hospital staff, and insurers to negotiate length of stay and level of care.
• Coordinate utilization review activities with other departments to ensure appropriate reimbursement.

Education

Bachelor's degree in Nursing or Master’s Degree in human services field preferred

Job description

Responsibilities

We are now offering a $5,000 sign-on bonus for our Utilization Review Director opening!

Gulfport Behavioral Health System is an acute behavioral health hospital on the Mississippi Gulf Coast providing inpatient, partial hospitalization and outpatient services to children, adolescents, and adults. We have served our community for over 30-years and our Patriot Support Program provides inpatient around-the-clock mental health treatment to help military members and their families, veterans, and first responders cope with stressful issues every day.

Visit us online at: https://gulfportbehavioral.com

The Director of Utilization Review : will assume responsibility for the functioning of the Utilization Review Department and provide utilization review services in a manner consistent with the philosophy and objectives of the facility; evaluates patient medical records to determine severity of patient’s illness and determines the appropriateness of level of care; serves as liaison for patients and hospital with insurance companies; negotiates and advocates for patient length of stay and level of care; oversees utilization review activities with other departments to ensure reimbursement for services provided by the hospital.

Benefit Highlights:

• Challenging and rewarding work environment
• Career development opportunities within UHS and its Subsidiaries
• Competitive Compensation
• Excellent Medical, Dental, Vision and Prescription Drug Plan
• 401(K) with company match and discounted stock plan
• Generous Paid Time Off
• Free Basic Life Insurance
• Tuition Reimbursement

About Universal Health Services

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

Education: Bachelor degree in Nursing or Master’s Degree in human services field preferred.

Experience: Minimum of 2 years clinical experience and 1 year of management experience with case management and the utilization review process including concurrent reviews. Previous continuum of care experience highly preferred.

Licensure: Current license in the state of Missisippi, including RN, LMSW, LMFT, LPC

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.

Avoid and Report Recruitment Scams

We are aware of a scam whereby imposters are posing as Recruiters from UHS, and our subsidiary hospitals and facilities. Beware of anyone requesting financial or personal information.

At UHS and all our subsidiaries, our Human Resources departments and recruiters are here to help prospective candidates by matching skill set and experience with the best possible career path at UHS and our subsidiaries. During the recruitment process, no recruiter or employee will request financial or personal information (e.g., Social Security Number, credit card or bank information, etc.) from you via email. Our recruiters will not email you from a public webmail client like Hotmail, Gmail, Yahoo Mail, etc.

If you suspect a fraudulent job posting or job-related email mentioning UHS or its subsidiaries, we encourage you to report such concerns to appropriate law enforcement. We encourage you to refer to legitimate UHS and UHS subsidiary career websites to verify job opportunities and not rely on unsolicited calls from recruiters.