Director of Utilization Review
UHS
Summary
Lighthouse Care Center of Augusta is seeking a dedicated, compassionate Director of Utilization Review to add to our growing team. Lighthouse Care Center of Augusta has been providing psychiatric services to the CSRA for more than 15-years. Located in Augusta, GA our 84-bed facility provides a therapeutic setting for those seeking treatment for mental illness.
Job description
The Director of Utilization Review is a key member of the Lighthouse Case Management Team who will integrate and coordinate a patient centric therapeutic strategy with a keen focus on clinical content; ensuring that delivery of high-quality and cost-effective treatment is consistent with the mission, vision, and values of Universal Health Services and in accordance with government regulation, licensing and accreditation requirements.
The Director of Utilization Review is responsible for the collection, analysis and articulation of required clinical data to insurance providers to obtain authorizations and ensure coordination with treatment services.
Job Duties/Responsibilities
- Working manager who oversees the Utilization Review coordinators
- Participate in treatment team meetings, collaborate with physicians, therapist, nurses and pertinent staff
- Authorizing entities to ensure initial precertification and continued authorization is achieved
- Responsible for aspects relative to timely gathering clinical criteria, communication of clinical criteria, and entry of supporting clinical criteria into computer based systems (Midas)
Requirements
- Masters Degree in nursing, social work, mental health counseling, or related field
- Minimum of five (5) years direct clinical experience in a psychiatric or mental health treatment setting
- Including one year of managing a related function preferred
- Experience in patient assessment, treatment planning and communication with external review organizations or comparable entities
- Licensure as RN, APRN, APC, LPC, LMSW, LCSW preferred
Benefits
- Referral Bonus Program
- Competitive Compensation
- Paid Time Off
- Medical, Dental & Vision
- Prescription Drug Plan
- 401(k) Matching
- Discounted Stock Plan
- Career Development
Company overview
Universal Health Services, Inc. (UHS) is one of the nation's largest and most respected providers of hospital and healthcare services, operating as a Fortune 300 corporation headquartered in King of Prussia, Pennsylvania. Founded in 1979, UHS has grown into a major healthcare enterprise with approximately 99,000 employees and annual revenues exceeding $14 billion. The company operates through its subsidiaries, managing 29 acute care hospitals, 331 behavioral health facilities, and 60 outpatient and other facilities across 39 U.S. states, Washington D.C., Puerto Rico, and the United Kingdom. UHS provides comprehensive healthcare services including acute care, behavioral health treatment, cancer centers, and ambulatory surgical centers. The company's strategy focuses on building or acquiring high-quality hospitals in rapidly growing markets and investing in advanced medical equipment and skilled personnel to become the leading healthcare provider in each community it serves. UHS is publicly traded on the New York Stock Exchange (NYSE: UHS) and has established a strong reputation for delivering compassionate, high-quality care while maintaining financial stability and operational excellence.