Utilization Review Manager: St. Louis Care Coordination

KVC Health Systems, Inc.; St. Louis, Northern (MO, KY); Hybrid; USD 75,000 - 105,000; Full time

Job summary

Camber, headquartered in St. Louis, seeks an experienced Utilization Review Manager to lead a team dedicated to clinical coordination and care optimization.

You will supervise UR Specialists, partner with physicians, nurses, and therapists, and ensure timely, accurate reviews and referrals within health plan guidelines. In this role you will drive department operations, manage data quality, participate in treatment teams, and uphold confidentiality and regulatory standards while promoting a

Qualifications

• Bachelor’s degree in a human service field such as social work, education, sociology, psychology, counseling, human relations, or criminal justice.
• Minimum of two years of experience in Utilization Review.
• At least one year of leadership experience.
• Valid driver’s license and auto insurance.
• MS Office proficiency (Word, Excel, Outlook).
• Strong English language skills, both verbal and written.

Responsibilities

• Direct supervision of Utilization Review Specialists to ensure task completion and policy compliance.
• Manage telephonic interfaces with health plans and provide clinical information from treatment teams.
• Lead departmental operations including oversight of responsibilities, evaluations, and workflow approvals.
• Compile and manage utilization review data with high attention to detail.
• Communicate with families, community partners, and service agencies while maintaining confidentiality.
• Participate in treatment team meetings to ensure continuity of care.

Skills

Leadership

Microsoft Office (Word, Excel, Outlook

English proficiency

Education

Bachelor’s degree in human service field

MOPRO licensure (preferred)

Job description

Camber, headquartered in St. Louis, seeks an experienced Utilization Review Manager to lead a team dedicated to clinical coordination and care optimization.

You will supervise UR Specialists, partner with physicians, nurses, and therapists, and ensure timely, accurate reviews and referrals within health plan guidelines. In this role you will drive department operations, manage data quality, participate in treatment teams, and uphold confidentiality and regulatory standards while promoting a