Manager-Utilization Management
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DescriptionLife Healing Center is nestled in the beautiful Sangre de Cristo mountains of Santa Fe, New Mexico. We are a well-established 46-bed residential program for adults suffering with complex trauma, primary mental health issues and addiction. For the past 30 years, our team of behavioral health professionals has held space for profound healing and recovery.We currently offer detox, residential, and partial hospitalization levels of care. Our therapeutic programming draws upon evidence-based approaches including CBT, DBT and trauma informed therapies such as psychodrama, art therapy and somatic psychotherapy. Individual and group therapy are enhanced by our adjunctive services including equine therapy, & EMDR,The Manager UM will 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.Licensed LPN or RN, or Associate's Degree, Bachelor's Degree in Social Work, behavioral or mental health, Nursing or other related health field; Master's degree in Social Work, Counseling, Nursing, or related health field preferred. Four or more year's clinical experience with the population of the facility and previous experience in utilization management preferred. One or more years of supervisory experience required.QualificationsSkillsRequired
Written Communication: Advanced
Typing: Advanced
Ten key: Intermediate
Safety Minded: Advanced
Problem Solving: Advanced
Planning & Organizing: Advanced
Oral Communication: Advanced
Networking: Advanced
Negotiating: Advanced
Leadership: Advanced
Innovation: Advanced
Financial Awareness: Advanced
Customer Focus: Advanced
Communication: Advanced
Computer - Word: Advanced
Computer - Excel: Advanced
Attention to Detail: Advanced
BehaviorsRequired
Thought Provoking: Capable of making others think deeply on a subject
Team Player: Works well as a member of a group
Loyal: Shows firm and constant support to a cause
Leader: Inspires teammates to follow them
Innovative: Consistently introduces new ideas and demonstrates original thinking
Functional Expert: Considered a thought leader on a subject
Enthusiastic: Shows intense and eager enjoyment and interest
Detail Oriented: Capable of carrying out a given task with all details necessary to get the task done well
Dedicated: Devoted to a task or purpose with loyalty or integrity
MotivationsRequired
Work-Life Balance: Inspired to perform well by having ample time to pursue work and interests outside of work
Self-Starter: Inspired to perform without outside help
Peer Recognition: Inspired to perform well by the praise of coworkers
Job Security: Inspired to perform well by the knowledge that your job is safe
Growth Opportunities: Inspired to perform well by the chance to take on more responsibility
Goal Completion: Inspired to perform well by the completion of tasks
Flexibility: Inspired to perform well when granted the ability to set your own schedule and goals
Financial: Inspired to perform well by monetary reimbursement
Entrepreneurial Spirit: Inspired to perform well by an ability to drive new ventures within the business
Ability to Make an Impact: Inspired to perform well by the ability to contribute to the success of a project or the organization
EducationRequired
Associates or better in Nursing/Healthcare
Preferred
Masters or better in Psychology
Bachelors or better in Psychology
ExperienceRequired
4 years: 4 Years Minimum
Equal Opportunity Employer/Protected Veterans/Individuals with DisabilitiesThe contractor will not discharge or in any other manner discriminate against employees or applicants because they have inquired about, discussed, or disclosed their own pay or the pay of another employee or applicant. However, employees who have access to the compensation information of other employees or applicants as a part of their essential job functions cannot disclose the pay of other employees or applicants to individuals who do not otherwise have access to compensation information, unless the disclosure is (a) in response to a formal complaint or charge, (b) in furtherance of an investigation, proceeding, hearing, or action, including an investigation conducted by the employer, or (c) consistent with the contractor’s legal duty to furnish information. 41 CFR 60-1.35(c)
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