Supervisor Behavioral Health Utilization Review

About the role

The Supervisor of Behavioral Health Utilization Review at Saint Luke’s Crittenton Children’s Center in South Kansas City, MO is responsible for overseeing the Utilization Review Department, Case Management, and Reception teams. This role ensures compliance with regulations, analyzes denials and authorizations, and builds strong relationships with third-party payers.

Responsibilities

• Facilitates and directs the Utilization Review Department, Case Management, and Reception teams.
• Ensures compliance with all pertinent regulations.
• Analyzes trends related to denials and authorizations.
• Buils strong relationships with third party payers.
• Ensures empathic and timely responses to individual patient and community needs through positive relationships with physicians, nursing supervisors, and senior administration.
• Supervises and completes daily operations as assigned by the Manager of Intake and Utilizations Review.
• Oversees resources and functions related to utilization review and regulatory compliance adherence.
• Responsible for training of staff, discipline, and evaluations.
• Maintains data to achieve quality outcomes and progress with the departmental strategic plan.
• Collaborates and communicates with the multidisciplinary team to ensure communication of patient’s treatment to the managed care provider.
• Reviews clinical charts to file appeals on denied accounts.
• Oversees scheduling and supervision needs for the Reception team.

Requirements

• Applicable Experience: 2 years Licensed Professional Counselor - Various
• Master's Degree