Competitive salary commensurate with experience; n...
Utilization review of admissions and continued stays
Supervision of um staff and performance management
Insurance verification and pre-certification coordination
The Director of Utilization Management is responsible for leading the overall management of the UM department and ensuring compliance with clinically valid criteria
Job Summary
The Director of Utilization Management is responsible for leading the overall management of the UM department and ensuring compliance with clinically valid criteria.
This role requires managing day-to-day operations, supervising staff on insurance verifications, and coordinating appeals to optimize facility reimbursement.
Palms Behavioral Health offers a comprehensive benefit plan and a competitive salary commensurate with experience and qualifications.
Matching Summary
The Director of Utilization Management is responsible for leading the overall management of the UM department and ensuring compliance with clinically valid criteria.
Salary
Competitive salary commensurate with experience; Not specified; Comprehensive benefit plan included
Skills & Requirements
Must-have
Utilization review of admissions and continued stays
Supervision of UM staff and performance management
Insurance verification and pre-certification coordination
Appeals processing for claim denials
Concurrent and retrospective medical record reviews
Nice-to-have
Experience with Veterans specialized programming
Strong multidisciplinary team collaboration skills
Ability to mitigate utilization issues proactively
Key Requirements
Bachelor's degree in nursing, social work, or related field (Master's preferred)
Six or more years of clinical experience with the facility population
Four or more years of medical/psychiatric utilization management experience
Current licensure as LPN, RN, or clinical professional license in Texas
Minimum three years of supervisory experience in clinical setting