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Utilization Management

3 months ago

Columbus, United States RiverVista Health and Wellness Full time

Role: UM Director

Job Post Title: Utilization Review Director

Shift: M-F

Hours: 8-4:30 9-5

The Role Itself  

  • Oversees service requests, authorizations and LOS metrics.

  • Reviews documentation quality for clinical effectiveness in regards to reimbursement.

  • Participates in clinical team for goal alignment and compliance.

  • Manages patient transitions between LOC and updates denial log.

  • Develops processes to minimize denials and provides education.

  • Possesses strong knowledge of external review organizations.

  • Facilitates UM team meetings.

Who we are

Our team at RiverVista Behavioral Hospital provides professional, compassionate care for adults and seniors in need of behavioral health services in the Columbus, Oh area. Specializing in treatment of symptoms associated with depression, anxiety, acute psychosis and other mental health crises. Our team of highly trained doctors and clinicians work closely to develop and oversee individualized care plans, with the goal of building the self-reliance and confidence needed for individuals to integrate safely back into their communities.

Perks with us

  • Medical Packages with Rx – 3 Choices

  • Flexible Spending Accounts (FSA)

  • Dependent Care Spending Accounts

  • Health Spending Accounts (HSA) with a company match 

  • Dental Care Program – 2 choices

  • Vision Plan

  • Life Insurance Options 

  • Accidental Insurances 

  • Paid Time Off + Paid Holidays

  • Employee Assistance Programs 

  • 401k with a Company Match

Education + Leadership Development 

  • Up to $15,000 in Tuition Reimbursements 

  • Student Loan Forgiveness Programs

Education:

  • Related and relevant field experience

  • Or Bachelor's Degree in Nursing, Social Work, Mental Health/Behavioral Sciences,

  • Or Master's Degree 

  • Must be 21 yrs or older

License:

  • LPN, RN, LMSW, LPC, BSW, LSW, LPCC, LISW or applicable license preferred.

Our overall mission is to Inspire Hope, Restore Peace of Mind and Heal Lives.