UR Supervisor

Tarzana Treatment Centers, Inc. is looking for a licensed mental health professional and or LPHA to supervise utilization management for our Behavioral Health continuum and implement a robust UR process that oversees treatment authorizations, medically necessary continued stays, and next level of specialty care decisions. The ideal candidate will have outstanding customer service that exceeds expectations of patients' visitors, physicians, and team members both external and internal. Strong working knowledge of the ASAM Criteria is a must as is Behavioral Health and experience working collaboratively with private and public Health Plans. The position requires knowledge of electronic systems and aggregated patient data for an organized UR process that determines care decisions, stratifies high risk, high utilizers, and other groups for best outcomes. Candidate must have experience working with private health plan Care Managers and public QIUM. Supervisor of UM will be versed in and work with Benefit Specialists, Patient Navigation, Providers from all disciplines in a Hospital setting, Business Development and community partners to drive change for healthcare and or enhancements to contracts and services. The ideal candidate will have strong supervisory skills including training and can meet business plan objectives including cost effective care decisions that achieve best outcomes for patients and maximizes Tarzana Treatment Centers' full continuum. Candidates with QA experience is valuable to ensuring integrity of documentation via concurrent chart reviews and overall compliance to assure the medical necessity documentation of care decisions. Must have a master's or Doctorate degree in mental health i.e., social work, counseling, psychology and Licensed by the California Board of Behavioral Science as an LCSW or MFT or Board of Psychology PsyD preferred. A minimum of three years' in Utilization Management, behavioral health and Supervisory experience in a clinical setting. Excellent customer service. Excellent communication and written skills.

Created: 2024-10-22