Utilization Management/ Admissions Manager

Posted: Saturday, 12 April 2025
Valid Thru: Monday, 12 May 2025
Index Requested on: 04/12/2025 07:52:48
Indexed on: 04/12/2025 07:52:48

Location: Knoxville, TN, 37901, US

Industry: Advertising and Public Relations
Occupational Category: 13-0000.00 - Business and Financial Operations
Type of Employment: FULL_TIME

Knoxville Center for Behavioral Medicine is hiring!

Description:

Manager Utilization Management and Admissions Dept

GENERAL DESCRIPTION: Direct and manage the day-to-day operations of the Utilization Review and admissions department.

MINIMUM EDUCATION/EXPERIENCE/SKILLS:
  • Bachelor's Degree in clinical field or nursing, required. Master's Degree in clinical field preferred. 2 or more year's clinical experience with the population of the facility, previous experience in utilization management preferred.


LICENSES/DESIGNATIONS/CERTIFICATIONS:
  • Current licensure current clinical professional license or certification, as required, within the state where the facility provides,
  • LPN or RN within the state where the facility provides services;


ESSENTIAL FUNCTIONS: Are determined by the facility and may Include, but are not limited to the following:

  • Monitor utilization of continuum services and optimize reimbursement for the facility while maximizing use of the patient's provider benefits for their needs.
  • Responsible for the concurrent and retrospective review for all patients,
  • Act as a liaison between Medicaid reviewers/gatekeepers and the staff completing required paperwork to facilitate the Utilization Review and admissions process,
  • Work with physicians, therapist and nursing staff to provide optimal review based on patient
  • Work with ancillary services in order to prevent delays in
  • May review charts, make necessary recommendations to the physicians, In regard to utilization review and specific managed care issues.
  • Assist Director with managing the Um and admission dept. staff
  • Provide oversight and direction to utilization
    • Demonstrates customer service behaviors when interacting with patients, team members and guests.
    • Communicates patient information in a concise, accurate, timely, and
  • confidential manner.
    • Utilizes available resources to assist with communication needs
    • Ensures that accurate Information is communicated in a timely and effective manner throughout the hospital.
    • Maintains a collaborative relationship with other


    Professional Image and Behavior:
    • Adheres to the department hospital code
    • Focuses on the needs of the patients and
    • Avoids discussion of personal issues and/or complaints in the presence of the
    • Assumes responsibility for behaviors and actions; accepts constructive criticism

    in a positive manner.
    • Participates in opportunities to promote professional


    OTHER FUNCTIONS:

    • Performs other functions and tasks as assigned/needed.


..

Communication:
  • Uses language that is .. easily understood and appropriate for the specific

Responsibilities:

Please review the job description.

Educational requirements:

  • high school

Desired Skills:

Please see the job description for required or recommended skills.

Benefits:

Please see the job description for benefits.

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