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Wellington Regional Medical Center
DIR - UTILIZATION REVIEW / MGMTWellington Regional Medical Center • Augusta, GA, United States
DIR - UTILIZATION REVIEW / MGMT

DIR - UTILIZATION REVIEW / MGMT

Wellington Regional Medical Center • Augusta, GA, United States
30+ days ago
Job type
  • Full-time
Job description

Director Of Utilization Review

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. Lighthouse Care Center offers unique and individualized programming for adolescents and adults that sets us apart from many other treatment facilities, and our tenured team includes seasoned medical staff.

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. The population served are patients whose lives are disrupted or complicated by mental illness, behavioral disturbance, substance issues, or inability to function or maintain in the community.

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)

Benefit Highlights:

  • Referral Bonus Program
  • Challenging and rewarding work environment
  • Competitive Compensation & Generous Paid Time Off
  • Excellent Medical, Dental, Vision, and Prescription Drug Plans
  • 401(K) with company match and discounted stock plan
  • Career development opportunities within UHS and its 300+ Subsidiaries!
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DIR - UTILIZATION REVIEW / MGMT • Augusta, GA, United States

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