Utilization Review Manager - Home Care jobs in Georgia

Utilization Review Manager - Home Care ensures quality and level of care for patients are up to established standards and comply with federal, state, and local regulations. Investigates and resolves reports of inappropriate care. Being a Utilization Review Manager - Home Care may require a bachelor's degree. Typically reports to a head of a unit/department. To be a Utilization Review Manager - Home Care typically requires 4 to 7 years of related experience. Contributes to moderately complex aspects of a project. Work is generally independent and collaborative in nature. (Copyright 2024 Salary.com)

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Utilization Review (UR) Coordinator
  • Turning Point Care Center
  • Moultrie, GA FULL_TIME
  • Responsibilities:
    Great opportunity for someone with clinical experience as a Case Manager, Patient Care Advocate, Pre-Cert Nurse, or Clinical Liaison. Come experience a different side of providing quality patient care.

    Utilization Review (UR) Coordinator (Therapist or RN)

    The Utilization Review Coordinator works closely with the other staff of Utilization Review/Management, Intake, Business Office, Medical Records, Clinical Staff, Nursing, and providers to coordinate and communicate patient information to insurance companies for the assignment of benefits.

    • Performs clinical reviews over the telephone and electronically.
    • Utilizes ASAM criteria (DSM-V) to determine appropriateness of admission, continued stay, discharge criteria and identifies high-risk cases.
    • Adheres to accrediting and regulatory agency requirements in maintaining records to ensure compliance.


    Turning Point Care Center, LLC

    For more than 35 years, Turning Point Care Center has provided a place of healing and hope to adults who suffer from behavioral health disorders and/or substance abuse. We are committed to providing quality behavioral health care through our inpatient and outpatient gender specific programs in Moultrie, GA. Our serene, rural setting gives patients a secure environment where they can build their foundation for lifelong recovery. We believe in creating healthy communities, which start with healthy individuals, linked through sound relationships to their families, friends, neighbors and peers. Quality Healthcare is our passion, improving lives is our reward. We are working to change lives and transform the delivery of healthcare. Visit our website at https://turningpointcare.com/ to learn more!


    Join our team and discover a rewarding, fulfilling career. We offer a competitive and comprehensive benefits program. Additional benefit details provided at https://benefits.uhsguest.com . Choose “I am a Guest” to view options designed to enhance and promote our employees’ health and wellbeing.

    Qualifications:
    • RN: Bachelor's Degree
    • Counselor/Therapist: Master's degree in Psychology, Social Work or related field
    • Licensure is preferred through state composite board for nursing or counseling/therapy:
      • RN (BSN or MSN), LCSW, LPC, LMFT
    • Three (3) years of experience in chart analysis, utilization review, medical/clinical terminology, and acuity of illness


    This opportunity offers the following:

    • CEUs required for biannual licensure for therapists (provided for free without having to use leave to attend)
    • Rewarding work environment
    • Growth and Development Opportunities within UHS and its 300 Subsidiaries
    • Excellent Medical, Dental, Vision and Prescription Drug Plan
    • 401k plan with company match and discounted stock plan
    • SoFi Student Loan Refinancing Program


    Apply online at
    https://jobs.uhsinc.com/turning-point-care-center


    About Universal Health Services
    One of the nation’s largest and most respected providers of hospital and healthcare services, Universal Health Services, Inc. (UHS) has built an impressive record of achievement and performance. Growing steadily since its inception into an esteemed Fortune 500 corporation, annual revenues were $13.4 billion in 2022. During the year, UHS was again recognized as one of the World’s Most Admired Companies by Fortune; and listed in Forbes ranking of America’s Largest Public Companies. Headquartered in King of Prussia, PA, UHS has approximately 94,000 employees and continues to grow through its subsidiaries. Operating acute care hospitals, behavioral health facilities, outpatient facilities and ambulatory care access points, an insurance offering, a physician network and various related services located all over the U.S. states, Washington, D.C., Puerto Rico and the United Kingdom. www.uhs.com


    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.


    EEO Statement

    All UHS subsidiaries are committed to providing an environment of mutual respect where equal employment opportunities are available to all applicants and teammates. UHS subsidiaries are equal opportunity employers and as such, openly support and fully commit to recruitment, selection, placement, promotion and compensation of individuals without regard to race, color, religion, age, sex (including pregnancy, gender identity, and sexual orientation), genetic information, national origin, disability status, protected veteran status or any other characteristic protected by federal, state or local laws.


    We believe that diversity and inclusion among our teammates is critical to our success.


    Notice

    At UHS and all our subsidiaries, our Human Resources departments and recruiters are here to help prospective candidates by matching skillset and experience with the best possible career path at UHS and our subsidiaries. We take pride in creating a highly efficient and best in class candidate experience. During the recruitment process, no recruiter or employee will request financial or personal information (Social Security Number, credit card or bank information, etc.) from you via email. The recruiters will not email you from a public webmail client like Hotmail, Gmail, Yahoo Mail, etc. If you are suspicious of a job posting or job-related email mentioning UHS or its subsidiaries, let us know by contacting us at: https://uhs.alertline.com or 1-800-852-3449.


    Certification, Case Management, Pre-Cert, Behavioral Health, Commercial Insurance, Medicare, Patient Care, Advocate, Interqual, Case Management Certification (CCM), Utilization Management (UM)

  • 14 Days Ago

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Utilization Review Director
  • Coastal Behavioral Health
  • Savannah, GA FULL_TIME
  • Responsibilities: Coastal Harbor Health System offers compassionate care when you or your loved ones need it most. Our experienced team of doctors, nurses and therapists are specialists in behavioral ...
  • 3 Days Ago

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Utilization Review Specialist
  • RiverWoods Behavioral Health
  • Riverdale, GA FULL_TIME
  • PURPOSE STATEMENT: Proactively monitor utilization of services for patients to optimize reimbursement for the facility. ESSENTIAL FUNCTIONS: · Act as liaison between managed care organizations and the...
  • 4 Days Ago

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Director- Utilization Review
  • Greenleaf Behavioral Health Hospital
  • Valdosta, GA FULL_TIME
  • Provides accurate and complete clinical information to payors based on synthesized documentation in the medical record. Conducts utilization review on all assigned cases and ensures authorizations are...
  • 4 Days Ago

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Utilization Review - NRN
  • Houston Medical Center
  • Warner Robins, GA FULL_TIME
  • Care Management Full Time · 8:00a - 4:00p · Call typically not required H14 The Non RN (NRN) Utilization Reviewer performs concurrent, extended stay and retrospective reviews of admissions using estab...
  • 1 Day Ago

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UTILIZATION REVIEW COORDINATOR
  • Archbold Medical Center
  • Thomasville, GA FULL_TIME
  • Utilication Review Coordinator - Patient AccessDescription:Skilled in assessing, planning and managing patient care delivery as acquired through clinical nurse experience Must be in good physical and ...
  • 14 Days Ago

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Environmental and Utilities Manager
  • Leprino Foods
  • Lubbock, TX
  • For our future state-of-the art 600+ person Lubbock, TX cheese and whey manufacturing facility, Leprino is seeking an En...
  • 6/11/2024 12:00:00 AM

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Gas Utilities Manager
  • Accenture
  • Austin, TX
  • We Are: Our Utility Industry, Transmission & Distribution Practice is powering the progress to a safe, connected, and su...
  • 6/10/2024 12:00:00 AM

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Director Utilization Management
  • Heritage Valley Health System, Inc.
  • Beaver, PA
  • Department: Utilization Review. Work Hours: Primarily Monday through Friday, extended hours as needed to support organiz...
  • 6/9/2024 12:00:00 AM

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Supervisor, Utilization Management
  • Centene Corporation
  • Tallahassee, FL
  • You could be the one who changes everything for our 28 million members as a clinical professional on our Medical Managem...
  • 6/9/2024 12:00:00 AM

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Utilization Management Specialist
  • Blue Cross and Blue Shield Association
  • Meridian, ID
  • Our Utilization Management Rep will coordinate and manage incoming and outgoing correspondence to include referrals, pri...
  • 6/9/2024 12:00:00 AM

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Director of Utilization Management
  • Oceans Healthcare
  • Jackson, MS
  • Description The Director Utilization Management is responsible for oversight and management of all utilization review/ca...
  • 6/8/2024 12:00:00 AM

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Manager, Utilization Management
  • Hiring Now!
  • New York, NY
  • Creates and upholds policies and procedures for coverage determinations. Serves as subject matter expert for Medicare co...
  • 6/8/2024 12:00:00 AM

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Director Utilization Management
  • Heritage Valley Health System
  • Beaver, PA
  • Department: Utilization Review Work Hours: Primarily Monday through Friday, extended hours as needed to support organiza...
  • 6/7/2024 12:00:00 AM

Georgia is a state in the Southeastern United States.Beginning from the Atlantic Ocean, the state's eastern border with South Carolina runs up the Savannah River, northwest to its origin at the confluence of the Tugaloo and Seneca Rivers. It then continues up the Tugaloo (originally Tugalo) and into the Chattooga River, its most significant tributary. These bounds were decided in the 1797 Treaty of Beaufort, and tested in the U.S. Supreme Court in the two Georgia v. South Carolina cases in 1923 and 1989. The border then takes a sharp turn around the tip of Rabun County, at latitude 35°N, thou...
Source: Wikipedia (as of 04/17/2019). Read more from Wikipedia
Income Estimation for Utilization Review Manager - Home Care jobs
$74,055 to $94,408