Director of Utilization Review

19 hours ago


Smyrna, Georgia, United States Ridgeview Institute Smyrna Full time
Job Summary

We are seeking a highly skilled and experienced Director of Utilization Review to oversee our Utilization Review Program. The successful candidate will be responsible for implementing case management scenarios, consulting with all services to ensure the provision of an effective treatment plan for all patients, and interacting with managed care organizations, external reviewers, and other payors.

Key Responsibilities
  • Oversee the Utilization Review Program, ensuring compliance with regulatory requirements and company policies.
  • Implement case management scenarios to ensure effective treatment plans for patients.
  • Consult with all services to ensure seamless coordination of care.
  • Interact with managed care organizations, external reviewers, and other payors to ensure timely and effective resolution of service requests.

Requirements
  • Master's degree in nursing, social work, mental health/behavioral sciences, or related field.
  • At least five years of direct clinical experience in a psychiatric or mental health treatment setting, including one year of managing a related function.
  • Experience in patient assessment, family motivation, treatment planning, and communication with external review organizations or comparable entities.
  • R.N., S.W., or applicable Georgia license preferred.

What We Offer
  • 401(k) + matching
  • Health insurance
  • 100% company-paid life insurance coverage up to 2x your annual salary
  • Vision Insurance
  • Dental Insurance
  • 100% company-paid long-term disability insurance
  • Paid time off
  • Paid Holidays
  • Cafeteria on site
  • Employee engagement events
  • Employee assistance program
  • Employee recognition program
  • Free Parking

About Us

At Ridgeview Institute Smyrna, we value a diverse, inclusive workforce and provide equal employment opportunities for all applicants and employees. We do not discriminate based on race, religion, color, national origin, gender, sexual orientation, gender identity or expression, age, marital status, veteran status, disability status, pregnancy, parental status, genetic information, political affiliation, or any other status protected by the laws or regulations in the locations where we operate. Accommodations are available for applicants with disabilities. Ridgeview Institute Smyrna

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