UR Supervisor

This is a fully remote position, open to applicants in Arizona, +18 more states.

📋 Description

• Oversee and coordinate a team of Utilization Review (UR) specialists

• Act as a role model while providing daily service support and training

• Allocate cases to UR representatives and appeals specialists for initial authorizations and coverage matters

• Assess medical necessity, level of care, and the suitability of services based on clinical review criteria

• Initiate and execute process enhancements

• Organize staff education and the development and revision of policies and procedures

• Collaborate with Admissions, clinical, medical, billing, management, and other departments

• Schedule staff meetings with the UR manager and facilitate them as required

• Engage in departmental and divisional projects

• Maintain the role of UR specialist while managing a reduced caseload for Substance Use Disorder (SUD) and Mental Health (MH)

• Stay informed about the latest insurance payer requirements

• Ensure accurate documentation within Salesforce and Electronic Medical Record (EMR) systems

• Offer admissions guidance regarding authorizations and the risks associated with specific levels of care

• Assist the manager in fostering a positive work culture and promoting growth

• Carry out other assigned duties

⛳️ Requirements

• A minimum of five (5) years of experience in chart analysis and utilization review within the psychiatric and chemical dependency sectors is preferred

• Outstanding oral and written communication skills are essential for effective interaction with patients, physicians, staff, and administration

• Ability to positively influence others while demonstrating respect and compassion

• Capacity to manage emotions and impulses, maintaining composure in a fast-paced environment with frequent interruptions

• Strong work ethic grounded in proactivity and teamwork

• Proficient in navigating ambiguity through structured problem-solving techniques

• Proficient in Microsoft Office applications

• Experience with clinical decision-making criteria sets, such as Milliman and InterQual

• Knowledge of federal policy specifications for facility states and prospective facilities

• During remote work, ensure compliance with ergonomic requirements and maintain a distraction-free work environment

• Ability to operate a computer, phone, and standard office equipment

• Significant phone work involving both speaking and listening

• A Bachelor’s degree in psychology, mental health counseling, social work, or a related field is 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