Utilization Review Manager - Home Care jobs in Germantown, TN

Lakeside Behavioral Health System provides an excellent opportunity for those seeking to be part of a team-oriented and compassionate organization.  Our staff tell us that our team is their number one reason for working at Lakeside, although we offer competitive compensation, excellent comprehensive benefits, opportunities for advancement, tuition assistance, and paid time off.

 Since 1969, Lakeside has been the premier provider of specialized behavioral health and addictive disease services in the Memphis and Mid-South region. The 365-bed facility is one of the largest free-standing psychiatric hospital in the United States.  We are located on a serene 37-acre campus in northeast Shelby County, serving as the setting for the treatment for children, adolescents, young adults, adults and seniors. Lakeside’s comprehensive programs treat disorders such as bipolar disorder, psychological trauma, depression and anxiety, mental illnesses and addictive disease disorders such as alcoholism, drug addiction and substance abuse.

Job Description

The UR Director possesses knowledge of psychiatric clinical diagnosis and the ability to articulate those indicators professionally.  The UR Director evaluates patient medical records to determine severity of patient’s illness and determining the appropriateness of level of care.  Serves as liaison for patients and hospital with insurance companies.   Negotiates and advocates for patient length of stay and level of care.  Oversees utilization review activities with other departments to ensure reimbursement for services provided by the hospital.  The UR Director leads physician weekly staffing meetings and coordinates with physician’s outpatient offices for the purposes of billing.  The UR Director has a working knowledge of all levels of care offered and appropriately manages patient benefits.

This opportunity provides the following:

• UHS is challenging and rewarding work environment
• Growth and development opportunities within UHS and its subsidiaries
• Competitive Compensation
• Excellent Medical, Dental, Vision and Prescription Drug Plan for full-time and part-time positions
• 401k plan with company match for full-time and part-time positions
• Generous Paid Time Off

Job Requirements

Education:   Masters prepared healthcare leader/director (Nursing, Counseling, Psychology or Social Work).

Experience:   A minimum of 8-10 years of experience working in an acute inpatient psychiatric setting as a treatment team member or 5-7 years of experience in utilization management for both mental health and substance abuse behavioral health disorders.

Licensure/Certification:  Valid TN RN license required, LCSW, or LPC preferred.

Knowledge:   Knowledge of managed care payer business practices, behavioral health hospital operations and medical necessity determinations. Knowledge of Diagnostic and Statistical Manual of Mental Disorders (DSM-V) diagnostic codes with corresponding clinical assessment skills that support patient evaluation. Experience using data to identify trends. Ability to manage team productivity and compliance with required timelines. Excellent oral and written communication skills that drive departmental hospital engagement.

Universal Health Services (UHS)

One of the nation’s largest and most respected providers of hospital and healthcare services, Universal Health Services, Inc. has built an impressive record of achievement and performance. Growing steadily since its inception into an esteemed Fortune 500 corporation, annual revenues were $11.6 billion in 2020.  In 2021, UHS was again recognized as one of the World’s Most Admired Companies by Fortune; in 2020, ranked #281 on the Fortune 500; and listed #330 in Forbes ranking of U.S.’ Largest Public Companies.  Headquartered in King of Prussia, PA, UHS has 89,000 employees and through its subsidiaries operates 26 acute care hospitals, 334 behavioral health facilities, 39 outpatient facilities and ambulatory care access points, an insurance offering, a physician network and various related services located in 38 U.S. states, Washington, D.C., Puerto Rico and the United Kingdom.

At UHS and all its subsidiaries, our Human Resources departments and recruiters are here to help prospective candidates by matching skillset and experience with the best possible career path at UHS and our subsidiaries. We take pride in creating a highly efficient and best in class candidate experience. During the recruitment process, no recruiter or employee will request financial or personal information (Social Security Number, credit card or bank information, etc.) from you via email.  Additionally, recruiters will not email you from a public webmail client like Hotmail, Gmail, Yahoo Mail, etc.  If you are suspicious of a job posting or job-related email mentioning UHS or its subsidiaries, let us know by contacting our Compliance Hotline at: https://uhs.alertline.com  or 1-800-852- 3449.

EEO Statement

All UHS subsidiaries are committed to providing an environment of mutual respect where equal employment opportunities are available to all applicants and teammates. UHS subsidiaries are equal opportunity employers and as such, openly support and fully commit to recruitment, selection, placement, promotion and compensation of individuals without regard to race, color, religion, age, sex (including pregnancy, gender identity, and sexual orientation), genetic information, national origin, disability status, protected veteran status or any other characteristic protected by federal, state or local laws.   We believe that diversity and inclusion among our teammates is critical to our success.

Notice

At UHS and all our subsidiaries, our Human Resources departments and recruiters are here to help prospective candidates by matching skillset and experience with the best possible career path at UHS and our subsidiaries.  We take pride in creating a highly efficient and best in class candidate experience. During the recruitment process, no recruiter or employee will request financial or personal information (Social Security Number, credit card or bank information, etc.) from you via email. The recruiters will not email you from a public webmail client like Hotmail, Gmail, Yahoo Mail, etc. If you are suspicious of a job posting or job-related email mentioning UHS or its subsidiaries, let us know by contacting us at: https://uhs.alertline.com or 1-800-852-3449.