Utilization Review Manager

Job not on LinkedIn

🕒 September 28

🌪️ Kansas, Missouri – Remote

🌪️ Kansas – Remote 🏰 Missouri – Remote

💵 $55k - $70k / year

⏰ Full Time

🟡 Mid-level

🟠 Senior

👔 Manager

👻 Ghost score 0%

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KVC Health Systems

WebsiteLinkedInAll Job Openings

1001 - 5000 employees

🏥 Healthcare

💼 Consulting

🤝 Non-profit

💰 $400k Grant - KVC Health Systems on 2023-10

Healthcare • Consulting • Non-profit

KVC Health Systems is a national family of nonprofit organizations that provides comprehensive child welfare and behavioral health services, including foster care, adoption, in-home family strengthening, outpatient and inpatient children’s psychiatric treatment, residential programs, and related training and consulting. Operating across multiple states, KVC focuses on preventing child abuse and neglect, supporting family stability, and promoting mental wellness through trauma-informed care and community partnerships.

📋 Description

• Liaise between KVC treatment teams and external funding partners to manage clinical service reviews • Secure initial and continued inpatient stay authorizations through communication with funding source departments • 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 to ensure compliance and support for authorized services • Serve as a link between treatment teams, funding sources, and external partners • 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 effectively 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 • Supportive work environment • Work-life balance through Wellbeing, DEI+B, and Talent Development programs

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