Utilization Management Manager

UM Manager (Full-Time)
Knoxville Center for Behavioral Medicine - Knoxville, TN

Make a Lasting Impact in Behavioral Health Care

Knoxville Center for Behavioral Medicine is a comprehensive inpatient facility providing compassionate, evidence-based treatment for adults and geriatric patients experiencing acute behavioral health crises or substance use disorders.

We are currently seeking a dedicated and detail-oriented Utilization Management (UM) Manager to join our growing team.

In this essential administrative role, you'll support the Utilization Management department to help ensure patients receive the care they need-when they need it-by coordinating with insurance providers, clinicians, and the larger care team.
What You'll Do:


*
+ 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 process,
+ Work with physicians, therapist and nursing staff to provide optimal review based on patient needs.
+ Work with ancillary services in order to prevent delays in services.
+ May review charts, make necessary recommendations to the physicians, In regard to utlllzation review and specific managed care issues.
+ Provide oversight and direction to utilization staff.

Who You Are:


* A motivated and compassionate professional with a strong attention to detail.


* Comfortable interacting with healthcare professionals and insurance providers.


* Skilled at managing multiple priorities in a fast-paced environment.


* Strong communicator who can clearly explain clinical situations and advocate for patient care.

Qualifications:


* Required: Bachelor's degree in Nursing or another clinical field.


* Minimum of 2 years of experience in the behavioral health field.


* Certification as a Registered Addiction Specialist, Certified Substance Abuse Counselor, or a similar credential is preferred.

Why Work With Us?


* Be part of a mission-driven organization committed to behavioral health recovery and wellness.


* Work in a supportive, team-based environment that values your contributions.


* Play a key role in helping patients access vital care and support.


* Enjoy opportunities for professional growth and career advancement.

Additional Details:


* Position Type: Full-Time


* Location: Knoxville, TN


* Schedule: May require some flexibility based on workload.

This job description reflects general duties and responsibilities but may evolve based on organizational needs and priorities.

Ready to Join Our Team?
If you're passionate about mental health care, detail-oriented, and driven to make a difference behind the scenes...