Utilization Review Manager

Utilization Review Manager

Harbor Oaks Hospital, New Baltimore's leading Mental Health and Addiction Treatment Center is seeking a passionate Utilization Review Manager to work at our facility in New Baltimore, MI.

Non-Exempt Position

PRN Position

Monday - Friday - Day Shift

Rate of Pay : $25.00 - $35.00 per hour (based on experience)

Purpose Statement :

Monitor utilization of services and optimize reimbursement for the facility while maximizing use of the patient's provider benefits for their needs.

Essential Functions :

• Provide consultation and guidance regarding admissions and patient length of stay to a variety of payers.
• Secure authorizations with insurance companies for inpatient treatment and continue to obtain authorizations for duration of patient stay.
• Evaluate the utilization program for compliance with regulations, policies and procedures.
• Review clinical documentation from denied stays against criteria to determine if documentation is adequate for requested treatment.
• Provide staff management including hiring, development, training, performance management and communication to ensure effective and efficient department operation.

Other Functions :

Licenses / Designations / Certifications :