Utilization Review Management Jobs (NOW HIRING)

Responsibilities
Fort Lauderdale Behavioral Health Center , is a 182-bed, acute care psychiatric hospital located in the beautiful Oakland Park, neighborhood of Fort Lauderdale, FL. Fort Lauderdale Behavioral features individual units for children, adolescents, adults, and seniors, and offers inpatient acute care, partial hospitalization, and intensive outpatient programs. On average, over 10,000 patients receive care from our compassionate health care team each year. FLBHC provides innovative behavioral health treatment and academic services to children, adolescents, and young adults, including:

• 24/7 Clinical Assessment Center
• Inpatient Hospitalization
• Inpatient Program Residential Treatment Facility and Partial Hospitalization Behavioral Health Rehabilitative Services

We are currently looking for a Director Of Utilization Management to support our Fort Lauderdale, FL campus. The Director of Utilization Management is required to meet Foundations standards of customer service and best practices as well as adhere to UHS Code of Conduct. The person must demonstrate excellent interpersonal skills, unquestioned integrity and dedication to their responsibilities and Foundations mission. The Director of Utilization Management is also responsible for ensuring that the utilization review process meets the integrity standards set by FLBHC and UHS. The Director: interfaces with clinical staff as well as managed care organizations, external reviewers and other payers, ensures that information is communicated in a straightforward, unbiased and timely manner. The Director will ensure that the content is accurate and relevant so that recipients can make informed decisions as well as leads the coordination of appeals including tracking and facilitating of physician reviews.
The Director of Utilization Management is responsible for the implementation of systems and standards related to the utilization review function, including the implementation of the Utilization Management Plan and ensuring its adherence to all regulatory standards. The Director coordinates the decimation of information to the CEO, CFO, CMO, medical staff, CNO, Director of Compliance, and Director of Clinical Services in a way that facilitates meaningful decision making.
The Director of Utilization Management supports the quality of clinical services by identifying issues and trends preventing successful outcomes in treatment through the utilization review process. The Director supervises all Utilization Management activities, including conducting audits to assure medical necessity criteria is met and is clearly documented in the medical record, immediately resolving any issues when medical necessity criteria is not met or not clearly documented. The Director supervises the Utilization Management Coordinators and assures coverage of all UM related activities.
Qualifications
Fort Lauderdale Behavioral Health offers comprehensive benefits for the Director of Utilization Review position, such as:

• Challenging and rewarding work environment
• Competitive Compensation
• Excellent Medical, Dental, Vision, and Prescription Drug Plan
• Generous Paid Time Off

Requirements:
Masters degree in social work, counseling or related field with respective licensure (LSW, LCSW, LPC) required.
Must have 3-5 years of Utilization Management experience in a behavioral health inpatient and/or residential setting.
Must be familiar with a variety of insurances and funding streams, including commercial insurance, Medicare/Medicaid
Must be familiar with community based resources need to coordinate aftercare, both insurance funded and natural supports
Preferred experience with children and adolescents, and specifically individuals with Autism, intellectual disabilities, or other neurodevelopmental disabilities.
EEO Statement
All UHS subsidiaries are committed to providing an environment of mutual respect where equal employment opportunities are available to all applicants and teammates. UHS subsidiaries are equal opportunity employers and as such, openly support and fully commit to recruitment, selection, placement, promotion and compensation of individuals without regard to race, color, religion, age, sex (including pregnancy, gender identity, and sexual orientation), genetic information, national origin, disability status, protected veteran status or any other characteristic protected by federal, state or local laws.
We believe that diversity and inclusion among our teammates is critical to our success.
Notice
At UHS and all subsidiaries, our Human Resources departments and recruiters are here to help prospective candidates with matching skillset and experience with the best possible career at UHS and our subsidiaries. We take pride in creating a highly efficient and best in class candidate experience. During the recruitment process, no recruiter or employee will request financial or personal information (Social Security Number, credit card or bank information, etc.) from you via email. The recruiters will not email you from a public webmail client like Hotmail, Gmail, Yahoo Mail etc. If you feel suspicious of a job posting or job-related email, let us know by contacting us at: https://uhs.alertline.com or 1-800-852-3449