Competitive salary commensurate with experience; c...
Utilization review staff supervision
Insurance verification compliance
Clinical record appropriateness review
The Director of Utilization Management leads the department by reviewing admissions, continued stays, and discharge planning according to clinically valid criteria
Job Summary
The Director of Utilization Management leads the department by reviewing admissions, continued stays, and discharge planning according to clinically valid criteria.
This role requires managing a team to ensure timely insurance verifications, accurate medical record reviews, and effective coordination of insurance appeals.
Palms Behavioral Health offers a comprehensive benefit plan and competitive salary while encouraging applications from veterans and military spouses.
Matching Summary
The Director of Utilization Management leads the department by reviewing admissions, continued stays, and discharge planning according to clinically valid criteria.
Salary
Competitive salary commensurate with experience; Comprehensive benefit plan included
Skills & Requirements
Must-have
Utilization Review staff supervision
Insurance verification compliance
Clinical record appropriateness review
Admission and discharge planning
Insurance denial appeals management
Concurrent and retrospective reviews
Nice-to-have
Leadership in mental health settings
Experience with Medicaid reviewers
Collaboration with multidisciplinary teams
Motivating high engagement staff
Problem-solving for payment issues
Key Requirements
Bachelor's degree in nursing or social work required
Master's degree in related field preferred
Six years clinical experience with facility population preferred
Four years medical/psychiatric utilization management experience required
Current LPN, RN, or clinical professional license required
Three years supervisory experience in clinical setting required