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Lead Utilization Case Manager

1 month ago

Dover, United States Universal Health Services Full time
Responsibilities

Lead Utilization Case Manager - Full-Time

We are seeking a Lead Utilization Case Manager to provide leadership support for the Utilization Management department in proactively monitoring utilization of continuum services and optimize reimbursement.

Dover Behavioral Health System is a 104-bed, acute care psychiatric hospital located in the beautiful Dover, Delaware area. Dover Behavioral Health System features individual units for adolescents and adults 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 at Dover Behavioral Health System.

This opportunity offers working at a hospital known for its outstanding patient satisfaction, including ranking 6th for highest patient satisfaction in 2020 compared to over 200+ psychiatric hospitals. We attribute this success to our talented and dedicated staff. We are the best at what we do

Job Responsibilities:

  • Assist the UM Director in training and mentoring Case Managers and Interns, and provide department orientation.
  • Support the UM Director in preparing and submitting appeals to third-party payers, ensuring all necessary data is collected to support claims.
  • Manage UM Case Managers' activities, including treatment team participation and monthly reports, in the absence of the UM Director.
  • Conduct admissions and concurrent stay reviews, maintain logs of reviews, and ensure timely communication with insurance companies regarding discharges.
  • Lead and represent the UM Department in meetings, perform internal utilization reviews, and adhere to hospital policies and safety standards.

Qualifications

Required Qualifications:

  • Master's prepared in social work, human services, or a related field OR a licensed nurse OR a combination of education and work experience
  • Demonstrated aptitude and experience in a leadership role

Shift:

  • Day Shift
  • Monday - Friday

About Our Parent Company (Universal Health Services):

One of the nation's largest and most respected providers of hospital and healthcare services, Universal Health Services, Inc. (UHS) has built an impressive record of achievement and performance. During the year, UHS was again recognized as one of the World's Most Admired Companies by Fortune; and listed in Forbes ranking of America's Largest Public Companies. Operating acute care hospitals, behavioral health facilities, outpatient facilities and ambulatory care access points, an insurance offering, a physician network and various related services located all over the U.S. States, Washington, D.C., Puerto Rico and the United Kingdom. www.uhs.com

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.

Avoid and Report Recruitment Scams

At UHS and all our subsidiaries, our Human Resources departments and recruiters are here to help prospective candidates by matching skill set and experience with the best possible career path at UHS and our subsidiaries. During the recruitment process, no recruiter or employee will request financial or personal information (e.g., Social Security Number, credit card or bank information, etc.) from you via email. Our recruiters will not email you from a public webmail client like Hotmail, Gmail, Yahoo Mail, etc.

If you suspect a fraudulent job posting or job-related email mentioning UHS or its subsidiaries, we encourage you to report such concerns to appropriate law enforcement. We encourage you to refer to legitimate UHS and UHS subsidiary career websites to verify job opportunities and not rely on unsolicited calls from recruiters.