Utilization Manager
Our Utilization Manager is essential to patient care. This position is responsible for overseeing, utilization of services and optimizing reimbursement for the facility while maximizing use of the patient's provider benefits for their needs. They Utilization team work closely with our clinical and medical departments to ensure medical necessity is documented.
Essential Job Functions:
- Provide consultation and guidance regarding admissions and patient length of stay to a variety of payers.
- Secure authorizations with insurance companies for inpatient treatment and continue to obtain authorizations for duration of patient stay.
- Evaluate the utilization program for compliance with regulations, policies and procedures.
- Review clinical documentation from denied stays against criteria to determine if documentation is adequate for requested treatment.
- Provide staff management including hiring, development, training, performance management and communication to ensure effective and efficient department operation.
Requirements:
- Bachelor's degree required.
- One or more years supervisory experience required.
- Four or more years' clinical experience with the population of the facility and previous experience in utilization management required.
- Teamwork and excellent customer service.
- CPI and CPR Certifications (offered on site).
- Bachelor's or master's degree in social work, behavioral or mental health, Nursing or other related health field preferred.
- Licensed Clinician preferred.
Benefits:
- UMR Health Insurance (3 plans to choose from, eligible after 30 days of employment).
- Delta Dental (2 plans to choose from).
- VSP Vision Insurance.
- Paid life and AD&D insurance.
- 401k with a matching contribution.
- Paid Vacation/Sick/Extended Sick/Personal/Holiday time.
- Short term and Long term disability.
- License/certification renewal and CEU reimbursement.
- Free onsite employee fitness center.
- Free meals.
- Employee Discount program.
- Employee Fun events.
- Annual performance review and Merit increase review.
- Salary increases for obtaining education degrees, professional certification and/or licensure (based on program of study/field of certification and licensure).
For the 5th consecutive year, Wilmington Treatment Center has been recognized by Newsweek magazine as one of the best Addiction Treatment Centers in the US. We are North Carolina's premier substance abuse recovery hospital and rehabilitation center located in the beachside community of Wilmington, NC. What began as a 22 bed hospital on one campus in 1984 has grown into a 260 bed hospital spanning 3 campuses - and we are still growing! We are a team of professionals dedicated to helping our patients begin their recovery from the disease of addiction. Even though we are growing, we still maintain that feeling of a close-knit community. We offer a fantastic comprehensive benefit package, a great team of co-workers as well as the opportunity to make a difference in the lives of those we serve.
Equal Opportunity Employer/Protected Veterans/Individuals with Disabilities This employer is required to notify all applicants of their rights pursuant to federal employment laws. For further information, please review the Know Your Rights notice from the Department of Labor.