DIR - UTILIZATION REVIEW / MGMT

About the role

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 offers a therapeutic setting for those seeking treatment for mental illness. We provide unique and individualized programming for adolescents and adults, supported by a tenured team of seasoned medical staff.

The Director of Utilization Review is a key member of the Lighthouse Case Management Team, integrating and coordinating a patient-centric therapeutic strategy with a focus on clinical content. This role ensures the delivery of high-quality and cost-effective treatment consistent with the mission, vision, and values of Universal Health Services, while adhering to government regulations, licensing, and accreditation requirements. The Director is responsible for collecting, analyzing, and articulating required clinical data to insurance providers to obtain authorizations and ensure coordination with treatment services. The population served includes patients whose lives are disrupted or complicated by mental illness, behavioral disturbances, substance issues, or an inability to function or maintain in the community.

Responsibilities

• Act as a working manager overseeing Utilization Review coordinators
• Participate in treatment team meetings and collaborate with physicians, therapists, nurses, and pertinent staff
• Engage with authorizing entities to ensure initial precertification and continued authorization is achieved
• Oversee timely gathering, communication, and entry of supporting clinical criteria into computer-based systems (Midas)

Requirements

• Master’s Degree in nursing, social work, mental health counseling, or a related field, with licensure (e.g., RN, APRN, LPC, LMSW, LCSW)
• A minimum of five (5) years of direct clinical experience in a psychiatric or mental health treatment setting
• At least one year of experience managing a related function preferred
• Experience in patient assessment, treatment planning, and communication with external review organizations or comparable entities

Benefits

• Referral Bonus Program
• Challenging and rewarding work environment
• Competitive compensation and 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 the UHS Benefits Guest Website.

About the organization

Universal Health Services (UHS) is one of the nation’s largest and most respected providers of hospital and healthcare services. Headquartered in King of Prussia, PA, UHS has 99,000 employees and operates 28 acute care hospitals, 331 behavioral health facilities, and 60 outpatient and other facilities across 39 U.S. states, Washington, D.C., Puerto Rico, and the United Kingdom.