Insurance Utilization Reviewer Jobs in Louisiana

NOTE: this position is currently filled. However, it is the policy of Freedom Behavioral to continue to
take applications so that we can ensure there is no disruption in patient care if a vacancy occurs.

Freedom Behavioral Lake Charles is a rapidly expanding psychiatric hospital committed to providing compassionate, high-quality care to both adult and geriatric patients. We are proud to foster a positive, team-oriented environment where exceptional patient care and strong employee support remain at the center of everything we do. Since opening our first facility in Magnolia, Mississippi in 2015, Freedom Behavioral has continued to grow and now operates 12 facilities across Louisiana, Texas, and Mississippi.

As we continue to grow, we are excited to expand our Lake Charles team in preparation for increasing our capacity to 46 beds, allowing us to provide care and support to even more individuals within our community.

At Freedom Behavioral Lake Charles, our employees are the foundation of our success. Their dedication, compassion, and commitment make a meaningful impact every day, and we are devoted to creating a workplace where team members feel appreciated, respected, and empowered to succeed. We proudly offer competitive compensation, opportunities for career advancement, ongoing education and training, and a strong commitment to promoting a healthy work-life balance.

If you are searching for more than just a careerif you are looking for purpose, professional growth, a supportive team environment, and the opportunity to truly make a difference in the lives of othersFreedom Behavioral Lake Charles is the place for you.

POSITION SUMMARY:

A Utilization Review (UR) Director at Freedom Behavioral Hospital is responsible for overseeing utilization review and discharge planning processes in compliance with CMS, federal, and state regulations, as well as the organizations mission, policies, procedures, and performance improvement standards.

In this role, the UR Director works closely with admissions, medical providers, and clinical staff to ensure patients receive appropriate, medically necessary care throughout their stay. They review patient records to evaluate the medical necessity of admissions, treatment plans, and length of stay while ensuring compliance with insurance and government reimbursement requirements.

The UR Director manages utilization review activities, including precertification and continued stay authorizations, and serves as the primary point of contact for payor sources. They communicate admission and continued stay criteria with referral sources, families, insurance representatives, and the interdisciplinary treatment team to maintain effective coordination of care. Cases requiring additional clinical expertise are referred to the Medical Director for further review.

As a key member of the multidisciplinary team, the UR Director helps facilitate treatment team processes, supports discharge planning efforts, and promotes effective communication among departments. They also maintain performance improvement initiatives within the department and participate in quality management activities to support regulatory compliance and patient care excellence.

This position requires strong analytical, organizational, and communication skills, along with a commitment to maintaining the highest ethical standards regarding patient care, confidentiality, and patient rights.

PREFERRED KNOWLEDGE, SKILLS AND/OR EXPIERENCE:

Education: A degree in a social science is preferred or nursing education
License:
Experience: 1+ years coordinating utilization review and discharge planning activities

BENEFITS:

Challenging and rewarding work environment

Excellent staff to patient ratio
Competitive Compensation
Medical, Dental, Vision, and Prescription Drug Plan
Generous Paid Time Off
401(K) with company match

Freedom provides equal employment opportunities to all employees and applicants for employment and prohibits discrimination and harassment of any type without regard to race, color, religion, age, sex, national origin, disability status, genetics, protected veteran status, sexual orientation, gender identity, or any other characteristic protected by federal, state or local laws. This policy applies to all terms and conditions of employment, including recruiting, hiring, placement, promotion, termination, layoff, recall, transfer, leaves of absence, compensation, and training.

****All applicants selected for employment will be required to undergo a post-offer drug test and federal background investigation. ****