The UR Director position at Palms Behavioral Health in Harlingen, Texas, involves leading the Utilization Management department, overseeing staff, and ensuring compliance with medical and insurance standards. The role requires significant clinical and utilization management experience, along with strong leadership skills.
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Job Summary
The Director of Utilization Management is responsible for the overall management of the UM department by leading and facilitating review of assigned admissions, continued stays, utilization practices and discharge planning.
Leads a team of highly engaged members thru hiring, orienting, performance assessment and management, motivating, training, scheduling, and coaching to meet department goals and ensure effective and efficient department operation.
Palms Behavioral Health offers a comprehensive benefit plan and a competitive salary commensurate with experience and qualifications.
Matching Summary
Match Score: 85
The UR Director position at Palms Behavioral Health in Harlingen, Texas, involves leading the Utilization Management department, overseeing staff, and ensuring compliance with medical and insurance standards. The role requires significant clinical and utilization management experience, along with strong leadership skills.
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Skills & Requirements
Must-have
manage utilization review staff
ensure timely insurance verifications
review medical records for level of care
manage admissions and pre-certifications
appeal insurance denials
analyze client records for reimbursement
Nice-to-have
optimize reimbursement for facility
maximize client provider benefits
mitigate issues with utilization
serve veterans with specialized programming
Key Requirements
Graduation from accredited school of nursing OR Bachelor's degree in social work, behavioral or mental health, or related health field
Six or more years clinical experience with the population of the facility preferred
Four or more years experience in medical/psychiatric utilization management
Current licensure as LPN or RN or current clinical professional license or certification
CPR and de-escalation certification required
Minimum of three years supervisory experience in clinical setting/utilization