Ur Director

Palms Behavioral Health

Harlingen, Texas, US
Competitive salary commensurate with experience; c...
Utilization management department leadership
Insurance verification and pre-certification
Concurrent and retrospective case reviews
The Director of Utilization Management is responsible for leading the overall management of the UM department and supervising staff to ensure timely insurance verifications

Job Summary

  • The Director of Utilization Management is responsible for leading the overall management of the UM department and supervising staff to ensure timely insurance verifications.
  • This role requires analyzing client records to determine the appropriateness of admission and length of stay while ensuring compliance with government and insurance reimbursement policies.
  • Palms Behavioral Health offers a comprehensive benefit plan and a competitive salary commensurate with experience, with a specific dedication to serving Veterans.

Matching Summary

The Director of Utilization Management is responsible for leading the overall management of the UM department and supervising staff to ensure timely insurance verifications.

Salary

Competitive salary commensurate with experience; Comprehensive benefit plan included

Skills & Requirements

Must-have

  • Utilization Management department leadership
  • Insurance verification and pre-certification
  • Concurrent and retrospective case reviews
  • Medical record analysis for level of care
  • Appeals management for claim denials
  • Multidisciplinary team coordination

Nice-to-have

  • Experience with behavioral health population
  • Strong problem-solving skills
  • Motivating and coaching staff
  • Effective communication with managed care
  • Commitment to serving veterans

Key Requirements

  • Bachelor's degree in nursing or social work required
  • Six years clinical experience preferred
  • Four years medical/psychiatric utilization management experience required
  • Current LPN, RN, or clinical license required
  • Three years supervisory experience required
  • CPR and de-escalation certification required

Work Rights

Not specified

Tailored Resume

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