MGR - UTILIZATION REVIEW / MGMT

Willow Springs Center is looking for an experienced Utilization Management Manager to join our WSC team!

Located in the heart of the Sierras, Reno, Nevada provides a destination location where employees can live, work and play. The location itself is a benefit; not to mention Nevada has no state income tax. Working at Willow Springs Center means building a career that is dynamic and satisfying; having the opportunity to work and learn from some of Nevada's leading mental health professionals; and being a part of something meaningful that changes the world, one child at a time. Work at Willow Springs Center is a life path. At Willow Springs Center, we seek high performing, compassionate professionals dedicate to impacting the lives of youth ages 6 to 17 years of age. If you desire to make a difference through the work that you do, Willow Springs Center is the place for you.

Position Overview

The Utilization Management Manager is responsible for overseeing the Utilization Management Program for Inpatient and Outpatient services. This includes the implementation of case management scenarios, consulting with all services to ensure the provision of an effective treatment plan for all patients, oversees the response to requests for services and interfaces with managed care organizations, external reviewers, and other payors.

• Direct the response to request for services, including the initial response, the assessment and referral process, the designation of appropriate level of care, initiating of services, and follow up activity.
• Review the effectiveness of the comprehensive interface with external reviewers, communicates with external reviewers and managed care organizations to assure timely and appropriate interactions, monitor outcomes of reviews and provide consultation as needed.
• Review the quality of documentation provided at all levels of care to assure adequacy and clinical appropriateness.
• Assure patients are receiving effective and appropriate treatment, based on the level of care.
• Establish standards for customer relations and monitor the interactions between Case Management staff and customers to evaluate the effectiveness of customer service.
• Direct the program services offered, consulting with facility management in the planning, development, implementation and evaluation of the case management program.
• Maintain current awareness of mental health activities in the community.
• Maintain an awareness of community and market-related activities which includes knowledge of the activities of other providers, needs of local payers and the political climate related to mental health.
• Participate in clinical team analysis and evaluation of current services offered at the facility.
• Strategically solve problems that encompass the larger view of the organization, and establish goals by utilizing an understanding of organizational dynamics in planning and problem solving.
• Remain current on all clinical techniques, and provide direction to staff and facility personnel.
• Participate in developing, justifying and controlling the annual budget for department personnel, facilities and equipment.
• Ensure strategic program goals and objectives are consistent with overall facility goals and objectives.
• Develop goals and objectives, policies and procedures related to the operational needs of the programs scenarios.
• Consult with facility management in the development and facilitation of program activities which assure an optimal therapeutic experience for all patients
• Participate with ensuring that individual patients and their families are involved in the development of individualized treatment plans.
• Maintain an active involvement and awareness of all patient admissions, discharges and transfers.
• Meet regularly with program therapists and the Medical Director and program staff to ensure compliance with program goals and objectives.
• Serve on Facility Committees and attend meetings as assigned.
• Provide services to current referral sources to assure their satisfaction and continued associations.
• Develop and maintain a system to minimize and address denials in consult with the facility Business Office Manager and CFO.

Benefits for our team include:

• Tuition Assistance
• DBT Intensive training with Dr. Alan Fruzzetti
• DBT-PE training with Dr. Melanie Harned
• Career development opportunities across UHS and our 300+ locations!
• Diverse programming to expand your experience
• HealthStream online learning catalogue with plenty of free CEU courses
• Competitive Compensation & Generous Paid Time Off
• Excellent Medical, Dental, Vision and Prescription Drug Plans
• 401(K) with company match and discounted stock plan
• Pet Insurance
• SoFi Student Loan Refinancing Program
• 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. (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

Education: Bachelor's Degree in Nursing, Social Work, Mental health/behavioral sciences, or related field required; Master's Degree preferred.

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, family motivation, treatment planning and communication with external review organizations or comparable entities.

Licensure: R.N., L.M.S.W. or applicable license 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.

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.