Utilization Review Director

Three Rivers Behavioral Health is a 136-bed treatment facility that specializes in quality behavioral health and substance abuse services for adolescents and adults. We offer a full continuum of care through an integrated system of inpatient, partial hospitalization and intensive outpatient programs. Conveniently located between I-20 (Exit 61) and I-26 (Exit 110) in West Columbia, SC, our team of 300+ high quality employees describe working here as " family atmosphere," "supportive leadership," and "life-changing." Progressive professionals in the fields of psychiatry, medicine, nursing, social services, and activity therapy serve hundreds of adults and adolescents each month with the common goal of creating new beginnings. Healthcare professionals have a unique opportunity to affect lives for the better each and every day. Choose Three Rivers and start your life-changing journey today.

JOB SUMMARY: The Director is responsible for the management of the Utilization Review Department and the collection, aggregation, analysis, and reporting of complex clinical data. Will monitor adherence to the hospital's utilization review plan to ensure the effective and efficient use of hospital services.

KEY RESPONSIBILITIES:

Manages the review of medical records to determine the appropriateness of admissions, procedures, and the necessity of continued hospital stay, based on Centers for Medicare and Medicaid Services (CMS) guidelines.
Performs continuing review of the medical record, identifying the need for on-going hospitalization through the evaluation of clinical data documented in laboratory reports, radiology reports, and multidisciplinary progress notes. Identifies and certifies for billing and hospital utilization/case management purposes, the acute hospital length of stay authorized for each case.
Performs medical record reviews interpreting, abstracting, aggregating, analyzing and reporting complex clinical data obtained from medical records.

BENEFITS:

Career development opportunities across UHS and our 300+ locations!
Diverse programming to expand your experience
Competitive Compensation & Generous Paid Time Off
Excellent Medical, Dental, Vision and Prescription Drug Plans
Employee Assistance Program
401(K) with company match and discounted stock plan
Pet Insurance
SoFi Student Loan Refinancing Program
Tuition Assistance
Employee Referral Program
More information is available on our Benefits Guest Website: benefits.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. (UHS) has built an impressive record of achievement and performance. Growing steadily since its inception into an esteemed Fortune 500 corporation, annual revenues were $15.8 billion in 2024. UHS was again recognized as one of the World's Most Admired Companies by Fortune; listed in Forbes ranking of America's Largest Public Companies. Headquartered in King of Prussia, PA, UHS has approximately 99,000 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

Job Requirements

Masters' degree in a recognized mental health field or Registered Nurse

Minimum of two years psychiatric experience in chart analysis and in the utilization review field. One (1) year of management experience preferred.

Current RN license, LPC or LMSW preferred.

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.

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