Manager Utilization Management Jobs in Ferriday, LA

The Health Information Manager is responsible for the successful maintenance of patient records and the organizational and administrative operations of the Health Information Management (HIM) Department. This role manages all operational aspects of the department and serves as a resource for the facility regarding medical record content and regulatory requirements.

Key Responsibilities:

• Ensure the availability and integrity of medical records in accordance with hospital policy
• Manage operational aspects of the Health Information Management Department
• Serve as a resource to staff regarding medical record content, compliance, and regulatory standards
• Oversee Physician/LIP credentialing and recredentialing in compliance with company policies and procedures
• Ensure all duties are performed in accordance with facility policies, JCAHO standards, federal and state regulations, and QAPI standards

Utilization Review (UR) Role:

• Assist with coordination of insurance benefits for all patients across the organization
• Ensure preauthorization for covered days is obtained for all required third-party payers
• Communicate effectively with insurance companies, practitioners, therapists, nurses, and other staff to ensure utilization data is appropriately documented in medical records
• Maintain patient privacy by following hospital policy and federal privacy laws
• Maintain electronic insurance files for each patient admitted to the hospital
• Coordinate with the corporate office regarding utilization review activities
• Perform other duties as assigned to support department and facility operations

Education:

• Experience in Health Information Management or related field preferred

Experience & Skills:

• Prior experience in Health Information Management and Utilization Review in a hospital or healthcare setting
• Knowledge of medical record standards, regulatory requirements, and credentialing processes
• Strong organizational and communication skills
• Proficiency with electronic health records systems and insurance documentation
• Ability to maintain strict confidentiality and compliance with HIPAA regulations

Equal Employment Opportunity Statement

Freedom Behavioral Hospital of Ferriday provides equal employment opportunities to all employees and applicants and prohibits discrimination and harassment of any type. We do not discriminate based on 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.