UR Supervisor

Job not on LinkedIn

🔥 0 minutes ago

🌵 Arizona, Colorado, +17 more states – Remote

🌵 Arizona – Remote ⛰️ Colorado – Remote 🐊 Florida – Remote 🥔 Idaho – Remote 🌽 Illinois – Remote 🐎 Kentucky – Remote 🎰 Nevada – Remote 🗻 New Hampshire – Remote 🌪️ Oklahoma – Remote 🌲 Oregon – Remote 🦀 Maryland – Remote 🚗 Michigan – Remote 🏰 Missouri – Remote 🔔 Pennsylvania – Remote 🗿 South Dakota – Remote 🎸 Tennessee – Remote ⛷️ Utah – Remote ☕ Washington – Remote 🧀 Wisconsin – Remote

💵 $65k - $70k / year

⏰ Full Time

🟡 Mid-level

🟠 Senior

Apply Now

Find Similar Remote Jobs

Set Up Email Alert For New Jobs

📊 Check your resume score for this job

Improve your chances of getting an interview by checking your resume score before you apply.

Upload Resume

Sunshine Behavioral Health

WebsiteLinkedInAll Job Openings

201 - 500 employees

🏥 Healthcare

☁️ SaaS

Healthcare • SaaS

Sunshine Behavioral Health is a multi-location provider of substance use disorder and behavioral health treatment services. The organization operates residential and outpatient addiction treatment centers, medical detox, intensive outpatient, and aftercare programs across multiple states (California, Colorado, Illinois, Texas, Wisconsin, Pennsylvania). They offer individualized treatment plans including 12-Step and SMART Recovery options, holistic therapies, cellphone/laptop-friendly facilities, and programs addressing alcohol and various drug addictions and co-occurring mental health disorders. Sunshine assists with insurance verification (accepting major insurers like Cigna, Aetna, Anthem) and emphasizes compassionate, high-quality care and same-day admissions at some locations.

📋 Description

• Supervise and coordinate a team of UR specialists • Serve as a role model and provide day-to-day service support and training • Assign cases to UR representatives and appeals specialists for initial authorizations and coverage cases • Determine medical necessity, level of care, and appropriateness of services using clinical review criteria • Initiate and implement process improvements • Coordinate staff education and policy and procedure development and revision • Liaise with Admission, clinical, medical, billing, management, and other departments • Coordinate staff meetings with the UR manager and facilitate meetings as needed • Participate in department and division projects • Maintain the UR specialist role with a reduced SUD and MH caseload • Maintain current knowledge of insurance payer requirements • Maintain accurate documentation in Salesforce and EMR systems • Provide admissions guidance on authorizations and risks of admission to specific levels of care • Assist the manager in creating and maintaining a positive work culture and growth • Perform other duties as assigned

🎯 Requirements

• Five (5) years’ experience in chart analysis and utilization review in the psychiatric and chemical dependency field preferred • Exceptional oral and written communication skills required for clear, concise communication with patients, physicians, staff, and administration • Ability to positively influence others with respect and compassion • Ability to manage emotions and impulses and remain calm in a fast-paced environment with frequent interruptions • Strong work ethic based on proactivity and teamwork • Ability to navigate ambiguity using structured problem-solving techniques • Computer proficiency in Microsoft Office • Experience with clinical decision-making criteria sets such as Milliman and InterQual • Knowledge of federal policy specifications for facility states and future facilities • During remote work, responsibility for ergonomic requirements and a distraction-free work area • Ability to use a computer, phone, and typical office equipment • Significant phone work involving talking and listening • Bachelor’s degree in psychology, mental health counseling, social work, or another related field preferred

🏖️ Benefits

• 401(k) • 401(k) matching • Dental insurance • Disability insurance • Employee assistance program • Flexible spending account • Health insurance • Health savings account • Life insurance • Paid time off • Referral program • Vision insurance • Remote work