Utilization Manager- PHP (Remote)

Our Mission

Our mission is to offer innovative care solutions for the development of emotionally strong, personally responsible, and socially resilient girls and women. We are committed to maintaining a safe, nurturing environment where each girl or woman can benefit from superior individualized treatment provided by experienced professionals with relentless compassion and an unconditional joyful spirit.

Benefits

Timberline Knolls brings diversity and flexibility with our offers on competitive salary and an excellent benefits package. Our benefits package includes: paid time off, medical, dental, vision, disability, life insurance; and 401(k). TK also offers a supportive and diverse work environment, training in evidenced-based practices and substantial opportunities for growth.

 

ESSENTIAL FUNCTIONS:

Provide consultation and guidance regarding admissions and patient length of stay to a variety of payers.

Secure authorizations with insurance companies for inpatient treatment and continue to obtain authorizations through ongoing clinical reviews until patient discharges from treatment.

Evaluate the utilization operation for compliance with mandatory policies and procedures.

Review clinical documentation from denied stays against criteria to determine if documentation is adequate for requested treatment.

Maintain efficient, positive customer service attitude towards patients, their families and co-workers while being responsive to customer needs.

May provide oversight and direction to utilization staff.

This role is Remote.

OTHER FUNCTIONS:

Perform other functions and tasks as assigned.

Education

Bachelor's or better in Nursing/Healthcare or Psychology. 

Licenses & Certifications

Reg Nurse

CPR and de-escalation/restraint certification required (training available upon hire and offered by facility).

First aid may be required based on state or facility.