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MGR - UTILIZATION REVIEW - (6562)

Universal Health Services


Location:
HIGHLANDS RANCH, CO
Date:
11/16/2017
2017-11-162017-12-15
Job Code:
6562
Universal Health Services
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Job Details

Deltek Talent Management - MGR - UTILIZATION REVIEW - (6562)

Job Details


MGR - UTILIZATION REVIEW - (6562)

Facility Name
Highlands Behavioral Health
Location
HIGHLANDS RANCH, CO 80130 US (Primary)
Career Area
Professional
Category
Other
Job Description

Utilization Review Manager

 

Highlands BHS

Highlands Behavioral Health System is an 86 bed freestanding behavioral health hospital offering psychiatric care for adults and adolescents. Centrally located in Littleton, the facility is easily accessible to families throughout the Front Range and just minutes from surrounding communities.

 

Utilization Review Manager

The UR Manager manages the operations of the Utilization Management Department and ensures compliance with patient care quality standards.   The Manager coordinates activities in the process of evaluating the use of professional medical care, clinical services, facility procedures using pre-established criteria, performs oversight of admission pre-certification procedures and concurrent review of all patients using pre-established criteria.  Interfaces with other departments, mental health professionals and external review agencies and appeals adverse decisions by external review agencies

 

 

Essential Job Duties:

  • Manage, coordinate and control the overall operation of the Utilization Management Department.
  • Manage and coordinate the integration of the Utilization Management Department’s functions with other aspects of overall patient care.
  • Direct the Utilization Management Department’s performance improvement activities and ensures compliance with patient care and medical practice standards.
  • Manage and participate in the development/revision, implementation and communication of goals, policies, guidelines and standards for the Utilization Management Department in accordance with the facility’s policies, procedures, and objectives as well as Joint Commission, CMS, and other licensing standards.
  • Monitors admission and concurrent reviews of all patients, both internally and externally, as outlined in the Utilization Management Plan.
  • Functions as hospital intermediary with external review agencies.
  • Ensures that appropriate parties are notified in the event of an admission, or continuing stay denial.
  • Manages utilization data and information flow.
  • Serves as administrative staff member to the Committee of the Whole.
  • Participates in the educational process for the medical staff.
  • Collaborates with hospital personnel and medical staff to ensure optimal patient care.
  • Promotes a positive working environment and guest relations.
  • Assumes and/or performs additional duties as requested.
  • Promotes safety by attending mandatory in-services and complies with all safety measures initiated by the facility
  • mandatory in services and complies with all safety measures initiated by the facility
Job Requirements

Job Requirements:

  • Must be a graduate of an accredited Nursing or Social Work education program.

  • MSN or MSW preferred; or equivalent experience.

  • Prefer 5 years clinical experience with a psychiatric mental health population, 3 years experience in Utilization Management and prior supervisory experience.

  • Licensure and registration by the Colorado Dept. of Registration as an RN or licensed Social Worker preferred.

  • Possess knowledge of Utilization Management, insurance and managed care procedures related to a health care environment.

  • Current knowledge of regulatory/accrediting agency guidelines.

  • Basic computer proficiency and knowledge of statistical analysis required.

 

 

Knowledge/Skills:               

  • Must be able to perform assignments with minimal supervision;
  • Must be able to perform concentrated and/or complex mental activity with frequent involvement in complex and/or highly technical situations;
  • Must be able to work successfully under highly stressful conditions;
  • Must be able to make sound, independent judgments based on scientific and/or ethical principles;
  • Must be able to comprehend and perform oral and written instructions and procedures;
  • Must be able to collaborate with other multidisciplinary team members in an appropriate fashion;
  • Must be capable of adapting to varying workloads an work assignments on a constant basis;
  • Must have effective comprehensive reading skills, strong communication skills, written and verbal.

 

 

This opportunity offers the following:

  • Challenging and rewarding work environment
  • Growth and Development Opportunities within UHS and its Subsidiaries
  • Competitive Compensation
  • Excellent Medical, Dental, Vision and Prescription Drug Plan
  • 401k plan with company match

 

One of the nation’s largest and most respected hospital companies, Universal Health Services, Inc. (UHS) has built an impressive record of achievement and performance. Steadily growing from a startup to an esteemed Fortune 500 corporation, UHS today has annual revenue nearing $10 billion. In 2017, UHS was recognized as one of the World’s Most Admired Companies by Fortune; ranked #276 on the Fortune 500, and listed #275 in Forbes inaugural ranking of America’s Top 500 Public Companies.

 

Our operating philosophy is as effective today as it was 40 years ago: Build or acquire high quality hospitals in rapidly growing markets, invest in the people and equipment needed to allow each facility to thrive, and become the leading healthcare provider in each community we serve.

 

Headquartered in King of Prussia, PA, UHS has more than 81,000 employees and through its subsidiaries operates more than 320 acute care hospitals, behavioral health facilities and ambulatory centers in the United States, Puerto Rico, the U.S. Virgin Islands and the United Kingdom.

 

 

*UHS is a registered trademark of UHS of Delaware, Inc., the management company for Universal Health Services, Inc. and a wholly-owned subsidiary of Universal Health Services, Inc. Universal Health Services, Inc. is a holding company and operates through its subsidiaries including its management company, UHS of Delaware, Inc. All healthcare and management operations are conducted by subsidiaries of Universal Health Services, Inc. To the extent any reference to "UHS or UHS facilities" on this website including any statements, articles or other publications contained herein relates to our healthcare or management operations it is referring to Universal Health Services' subsidiaries including UHS of Delaware. Further, the terms "we," "us," "our" or "the company" in such context similarly refer to the operations of Universal Health Services' subsidiaries including UHS of Delaware. Any employment referenced in this website is not with Universal Health Services, Inc. but solely with one of its subsidiaries including but not limited to UHS of Delaware, Inc.

 

UHS is not accepting unsolicited assistance from search firms for this employment opportunity. Please, no phone calls or emails. All resumes submitted by search firms to any employee at UHS via-email, the Internet or in any form and/or method without a valid written search agreement in place for this position will be deemed the sole property of UHS. No fee will be paid in the event the candidate is hired by UHS as a result of the referral or through other means.

 

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