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Lighthouse Care Center of Augusta

Director - Utilization Review

Career Insights for Clinical Auditor / Utilization Reviewer

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What they do

A Clinical Auditor or Utilization Reviewer reviews the efficiency of healthcare delivery. Individuals tend to have had experience as a registered nurse or other healthcare delivery roles before transferring into this quality review role.

$96,007 / year median in Georgia

-6% projected decline

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Job Description

Director - Utilization Review Lighthouse Care Center of Augusta - 2.3 Augusta, GA Job Details Full-time 1 hour ago Benefits Disability insurance Health insurance Dental insurance Flexible spending account Paid time off Employee assistance program Vision insurance 401(k) matching Employee discount Professional development assistance Life insurance Referral program Qualifications LMFT Health insurance authorizations Direct patient care RN License
LMSW LPC
Master's degree LISW Data collection LCSW-C Full Job Description Lighthouse 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.
Website:
https://www.

LighthouseCareCenters.com 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 coordinators
  • Participate in treatment team meetings, collaborate with physicians, therapist, nurses and pertinent staff
  • Authorizing entities to ensure initial precertification and continued authorization is achieved
  • Responsible 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 Program
  • Challenging and rewarding work environment
  • Competitive Compensation & Generous Paid Time Off
  • Excellent Medical, Dental, Vision and Prescription Drug Plans
  • 401(K) with company match and discounted stock plan
  • Career development opportunities within UHS and its 300+ Subsidiaries!
  • More information is available on our
Benefits Guest Website:
uhsguest.com About Universal Health Services One of the nation's largest and most respected providers of hospital and healthcare services, Universal Health Services, Inc. (
NYSE:
UHS) has built an impressive record of achievement and performance, growing since its inception into a Fortune 500 corporation. Headquartered in King of Prussia, PA, UHS has 99,000 employees. Through its subsidiaries, UHS operates 28 acute care hospitals, 331 behavioral health facilities, 60 outpatient and other facilities in 39 U.S. States, Washington, D.C., Puerto Rico and the United Kingdom.
EDUCATION
Masters Degree in nursing, social work, mental health counseling, or related field required with licensure. (RN, APRN, LPC, LMSW, LCSW, LISW, 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.
Job Type:
Full-time Benefits:
401(k) matching Dental insurance Disability insurance Employee assistance program Employee discount Flexible spending account Health insurance Life insurance Paid time off Professional development assistance Referral program Vision insurance
Work Location:
In person