Utilization Review Manager

Summit Behavioral Health Corporation

Eolia, Missouri, US
Competitive salary commensurate with experience; c...
Supervise utilization review staff
Conduct concurrent and retrospective reviews
Verify client insurance benefits
The Utilization Review Manager leads the department to ensure timely insurance coverage and appropriate levels of care for clients

Job Summary

  • The Utilization Review Manager leads the department to ensure timely insurance coverage and appropriate levels of care for clients.
  • This role requires managing a team to conduct comprehensive reviews of medical records against established clinical criteria.
  • The Aviary Recovery Center offers a competitive salary and comprehensive benefit plan for qualified candidates.

Matching Summary

The Utilization Review Manager leads the department to ensure timely insurance coverage and appropriate levels of care for clients.

Salary

Competitive salary commensurate with experience; Comprehensive benefit plan included

Skills & Requirements

Must-have

  • Supervise utilization review staff
  • Conduct concurrent and retrospective reviews
  • Verify client insurance benefits
  • Manage insurance appeal denials
  • Ensure regulatory compliance standards

Nice-to-have

  • Experience in substance abuse settings
  • Strong multidisciplinary team communication
  • Optimizing reimbursement strategies
  • Collaborating with medical directors

Key Requirements

  • High School Diploma required; Bachelor's preferred
  • 2+ years clinical experience in substance abuse
  • 2+ years medical/psychiatric utilization management
  • Current LPN, RN, or clinical license required
  • Minimum 1 year supervisory experience required

Work Rights

Not specified

Tailored Resume

Cover Letter