Utilization Review Manager - Lead Clinical Coordination

St. Louis Children’s and KVC Health Systems; St. Louis (MO); On-site; USD 75,000 - 110,000; Full time

Job summary

Camber seeks an experienced Utilization Review Manager in St. Louis to lead a department responsible for managing patient stays with health plan interfaces. You will supervise UR Specialists, coordinate with physicians and treatment teams, and ensure policy compliance with Camber values.

The role emphasizes leadership, data accuracy, confidentiality, and collaboration with families and community partners. Strong English, a BS in a human service field, and UR experience are required; the

Qualifications

• Bachelor’s degree in a human service field such as social work, education, sociology, psychology, counseling, human relations, or criminal justice.
• A minimum of two years of experience in Utilization Review and at least one year of experience in a leadership role.
• Valid driver’s license and auto insurance.
• Intermediate proficiency with Microsoft Office, specifically Word, Excel, and Outlook.
• Strong command of the English language, both verbal and written, to conduct official administrative and operational business.

Responsibilities

• Direct supervision of Utilization Review Specialists to ensure task completion and policy compliance.
• Managing telephonic interfaces with health plans to provide clinical information developed by treatment teams.
• Leading departmental operations including oversight of responsibilities, performance evaluations, and approval of workflow.
• Compiling and managing utilization review data with high attention to detail and accuracy.
• Communicating effectively with diverse constituencies, including families, community partners, and service agencies.
• Maintaining the highest standards of confidentiality and adhering to regulatory procedures.
• Participating actively in treatment team meetings and staff conferences to ensure continuity of care.

Skills

Utilization Review

Leadership

Microsoft Office

Education

Bachelor's degree in human services

Bachelor’s degree in social work (preferred licensure)

Tools

Microsoft Word

Microsoft Excel

Microsoft Outlook

Job description

Camber seeks an experienced Utilization Review Manager in St. Louis to lead a department responsible for managing patient stays with health plan interfaces. You will supervise UR Specialists, coordinate with physicians and treatment teams, and ensure policy compliance with Camber values.

The role emphasizes leadership, data accuracy, confidentiality, and collaboration with families and community partners. Strong English, a BS in a human service field, and UR experience are required; the