Healthcare Utilization Manager
3 days ago
Our crisis stabilization units serve adults, adolescents, and children. Patients are often admitted involuntarily under the Baker Act. The typical length of stay on our units is 3-5 days.
We offer a competitive salary range of $65,000 - $85,000 per year, along with a comprehensive benefits package including dental insurance, health insurance, paid time off, training & development opportunities, vision insurance, and more.
Responsibilities:
- Review medical records and attend treatment team meetings to evaluate resource utilization and level of care.
- Develop effective communication strategies with insurers and third-party payers regarding referrals, admissions, medication changes, discharges, and changes in level of care.
- Coordinate on-site review of medical records with reviewers from third-party payers.
- Update patient and provider information using internal electronic records system.
- Arrange psychiatric consultations between internal and external providers.
- Investigate complaints, grievances, and medication variances. Report findings to Utilization Management Manager.
- Registered Nurse: Associate Degree in Nursing required; one year experience in psychiatric nursing required; valid Florida RN License required.
- Licensed Practical Nurse: Graduation from an accredited school of Practical Nursing required; two years experience in psychiatric nursing required; valid Florida LPN License required.
- Bachelors degree in Psychology or Human Services related field required; five years experience in the mental health field required; UM experience preferred.
- Masters degree in Psychology or Human Services related field required; three years experience in the mental health field required; UM experience preferred.
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