Utilization Review Manager

Job not on LinkedIn

🕒 Yesterday

🌪️ Kansas, Missouri – Remote

🌪️ Kansas – Remote 🏰 Missouri – Remote

💵 $55k - $70k / year

⏰ Full Time

🟡 Mid-level

🟠 Senior

👔 Manager

👻 Ghost score 0%

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KVC BEHAVORIAL HEALTHCARE

WebsiteLinkedInAll Job Openings

11 - 50 employees

🏥 Healthcare

🤝 Non-profit

🌍 Social Impact

Healthcare • Non-profit • Social Impact

KVC BEHAVORIAL HEALTHCARE is a U. S. -based nonprofit organization that provides behavioral health and child welfare services focused on children, families, and communities. KVC operates residential and community-based treatment programs, foster care and adoption services, and outpatient behavioral health services designed to improve mental health, family stability, and child safety.

📋 Description

• Serve as a link between treatment teams, funding sources, and external partners • Obtain and review clinical and medical service authorizations for clients at Great Circle locations • Communicate with funding source departments to secure initial and continued inpatient stay authorizations • Obtain transitional care authorizations • Provide necessary discharge information to external partners • Collaborate with admissions and statewide clinical teams • Analyze data to support treatment recommendations • Approve clinical documentation completed by program staff • Ensure compliance and support for authorized services • Report to the Utilization Review Manager Supervisor

🎯 Requirements

• Master’s Degree in Social Work, Counseling, Psychology, or a related field; OR an Associate degree in Nursing • Registered Nurse (RN) license is highly preferred; LPN licensure will be considered with appropriate experience • Experience working with commercial and managed Medicaid behavioral health plans • Experience securing continued stay authorizations for mental health services • Solid working knowledge of current CPT coding for behavioral health services • Familiarity with DSM diagnostic classification • Experience with accounting or claims for billing resolution • Valid Class E Driver’s License • Experience in a residential setting preferred • Experience working with children and families in a trauma-informed environment preferred • Deep understanding of clinical theory, therapy, and behavioral health systems • Ability to communicate complex psychiatric and medical information • Knowledge of community wrap-around services • Analytical ability to handle administrative details and prepare nonrecurring reports • Strong time management and organizational skills • Ability to work productively with individuals and families from diverse cultural backgrounds • Proficiency in PC-based software including Excel, Word, and Outlook • Superior oral and written communication skills • Ability to coordinate across remote teams

🏖️ Benefits

• Paid Time Off • Paid Parental Leave • Health, Dental, Vision & Life Insurance • 403(b) with Company Match • Tuition Reimbursement • Professional Licensure and Certification Reimbursement • Employee Assistance Program • Wellness Benefits, including health screenings and mental health support • Wellbeing, DEI+B, and Talent Development programs • Work-life balance