Director Of Utilization ReviewLighthouse Care Center of Augusta has been providing psychiatric services to the CSRA for more than 15 years. Located in Augusta, GA, our 84-bed facility provides a therapeutic setting for those seeking treatment for mental illness. Lighthouse Care Center offers unique and individualized programming for adolescents and adults that sets us apart from many other treatment facilities, and our tenured team includes seasoned medical staff.The Director of Utilization Review is a key member of the Lighthouse Case Management Team who will integrate and coordinate a patient-centric therapeutic strategy with a keen focus on clinical content; ensuring that delivery of high-quality and cost-effective treatment is consistent with the mission, vision, and values of Universal Health Services and in accordance with government regulation, licensing, and accreditation requirements. The Director of Utilization Review is responsible for the collection, analysis, and articulation of required clinical data to insurance providers to obtain authorizations and ensure coordination with treatment services. The population served are patients whose lives are disrupted or complicated by mental illness, behavioral disturbance, substance issues, or inability to function or maintain in the community.Job Duties/Responsibilities:Working manager who oversees the Utilization Review coordinatorsParticipate in treatment team meetings, collaborate with physicians, therapist, nurses, and pertinent staffAuthorizing entities to ensure initial precertification and continued authorization is achievedResponsible for aspects relative to timely gathering clinical criteria, communication of clinical criteria, and entry of supporting clinical criteria into computer-based systems (Midas)Benefit Highlights:Referral Bonus ProgramChallenging and rewarding work environmentCompetitive Compensation & Generous Paid Time OffExcellent Medical, Dental, Vision, and Prescription Drug Plans401(K) with company match and discounted stock planCareer development opportunities within UHS and its 300+ Subsidiaries!Qualifications:EDUCATION: Masters Degree in nursing, social work, mental health counseling, or related field required with licensure. (RN, APRN, LPC, LMSW, LCSW, etc)EXPERIENCE: A minimum of five (5) years direct clinical experience in a psychiatric or mental health treatment setting, including one year of managing a related function preferred.
Experience in patient assessment, treatment planning, and communication with external review organizations or comparable entities.