Director of Utilization Management/Review

Director of Utilization Review Management Opportunity

Cumberland Hall Hospital is a 97 bed, licensed, acute psychiatric hospital located in beautiful Hopkinsville, KY. Cumberland Hall features individual units for youth, adults and active-duty military, and offers inpatient acute care, partial hospitalization, and intensive outpatient programs. On average, over 1500 patients receive care from our compassionate health care team each year at Cumberland Hall Hospital.

Job duties to include:

• Oversees all utilization management functions.
• Oversees precertification, concurrent, and discharge utilization reviews.
• Facilitates regulatory compliance by ensuring proper documentation and allocation of treatment resources.
• Serves as a key member of the hospital management team.
• Acts as a key participant in hospital operations meetings that drive financial and clinical results.
• Functions as a key liaison with all hospital physicians to align physician engagement with payer expectations, patient acuity and discharge planning requirements.
• Leads payer engagement activities including post payment reviews, payer audit oversight and denial/appeal oversight.
• Oversees the Utilization Management committee structure.
• Develops and monitors utilization management plans.
• Manages utilization management staff and performs all administrative department head functions.
• This role will also be responsible for their own case-management load, while supporting and supervising the Utilization Review team.
• As a senior leader, the Director of Utilization Management is a working director participating as an administrator on call and working evenings and weekends as required to support the team.

Benefits for staff include:

• Challenging and rewarding work environment
• Competitive compensation and generous paid time off
• Excellent medical, dental, vision and prescription drug plans
• 401(k) with company match and discounted stock plan
• SoFi student loan refinancing program
• Retention bonus program
• Career development opportunities within UHS and its 300+ subsidiaries!

More information is available on our Benefits Guest Website: benefits.uhsguest.com

About Universal Health Services

One of the nation's largest and most respected providers of hospital and healthcare services, Universal Health Services, Inc. (UHS) has built an impressive record of achievement and performance. Growing steadily since its inception into an esteemed Fortune 500 corporation, annual revenues were $15.8 billion in 2024. UHS was again recognized as one of the World's Most Admired Companies by Fortune; and listed in Forbes ranking of America's Largest Public Companies. Headquartered in King of Prussia, PA, UHS has approximately 99,000 employees and continues to grow through its subsidiaries. Operating acute care hospitals, behavioral health facilities, outpatient facilities and ambulatory care access points, an insurance offering, a physician network and various related services located all over the U.S. States, Washington, D.C., Puerto Rico and the United Kingdom.

Qualifications

Director of Utilization Review Management Requirements:

• Education: Bachelor's Degree from an accredited college or university in Nursing, Master's Degree from an accredited college or university in nursing, social work, mental health, or related field preferred.
• Experience: A minimum of 3 years of experience working in an acute inpatient psychiatric setting as a treatment team member or 3-5 years of experience in utilization management for both mental health and substance abuse behavioral health disorders.

EEO Statement

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