The Utilization Management Manager 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 according to approved clinically valid criteria
Job Summary
The Utilization Management Manager 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 according to approved clinically valid criteria.
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.
Raleigh Recovery Center offers a comprehensive benefit plan and a competitive salary commensurate with experience and qualifications.
Matching Summary
The Utilization Management Manager 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 according to approved clinically valid criteria.
Skills & Requirements
Must-have
manage utilization review staff
review medical records
optimize reimbursement
coordinate with business office
conduct concurrent retrospective reviews
Nice-to-have
lead highly engaged members
support veterans and military spouses
problem solve and mitigate issues
Key Requirements
High School Diploma or equivalent required
Two or more years clinical experience in substance abuse setting
Two or more years experience in medical/psychiatric utilization management
Minimum of one year supervisory experience in clinical setting/utilization
Current licensure as LPN or RN or current clinical professional license or certification