Job Description

Job Description

Responsibilities

Havenwyck Hospital is a Joint Commission-accredited and licensed psychiatric hospital, overlooking Lake Galloway in Auburn Hills, Michigan. We specialize in providing comprehensive, compassionate behavioral health services to children, adolescents and adults.

It is the ultimate goal of our dedicated staff to build strength, confidence and knowledge within each patient, in hopes that they may continue learning and understanding their needs and practicing self-care for the rest of their lives.

Mission Statement: To provide individualized, quality behavioral health care, in a safe and secure environment where dignity and respect are upheld by our team of dedicated, caring, professional staff, in a cost-effective manner.

Havenwyck Hospital offers comprehensive benefits, such as:

* Challenging and rewarding, team-based work environment
* Competitive Compensation
* Excellent Medical, Dental, Vision, and Prescription Drug Plan
* Generous Paid Time Off
* 401(K) with company match and discounted stock plan
* Career development opportunities within UHS and its Subsidiaries

Havenwyck Hospital is part of one of the nation's largest and most respected hospital companies, Universal Health Services, Inc. (UHS) has built an impressive record of achievement and performance. Steadily growing from a startup to an esteemed Fortune 500 corporation, UHS today has annual revenue nearing $10 billion. In 2017, UHS was recognized as one of the World's Most Admired Companies by Fortune; ranked 276 on the Fortune 500, and listed 275 in Forbes inaugural ranking of America's Top 500 Public Companies.

Our operating philosophy is as effective today as it was 40 years ago: Build or acquire high quality hospitals in rapidly growing markets, invest in the people and equipment needed to allow each facility to thrive, and become the leading healthcare provider in each community we serve.

Headquartered in King of Prussia, PA, UHS has more than 81,000 employees and through its subsidiaries operates more than 320 acute care hospitals, behavioral health facilities and ambulatory centers in the United States, Puerto Rico, the U.S. Virgin Islands and the United Kingdom.

What do our current employees value at UHS?

An environment that puts patient care first. One of the most rewarding aspects of working at UHS is providing excellent care, comfort, and security to patients and families you treat, at their most vulnerable times. Having the opportunity to grow, learn, and advance in your career. There are very robust continuing education options and opportunities for leadership development with UHS.

Supportive and responsive leadership. Competitive salary and comprehensive benefits package.

Havenwyck Hospital is seeking a dynamic and talented Manager of Utilization Management to join our team of compassionate, dedicated professionals.

The Manager of Utilization Management is responsible for overseeing the Utilization Management Program for the Inpatient and Outpatient services. This includes the implementation of case management scenarios, consulting with all services to ensure the provision of an effective treatment plan for all patients, overseeing the response to requests for services and interfaces with managed care organizations, external reviewers and other payers.

Manager of Utilization Management duties include, but are not limited to:

Program Planning and Treatment

* Manage the response to requests for services, including the initial response, the assessment and referral process, the designation of appropriate level of care, initiating of services, and follow up activity.
* Review the effectiveness of the comprehensive interface with external reviewers, communicate with external reviewers and managed care organizations to assure timely and appropriate interactions, monitor outcomes of the reviews and provide consultation as needed.
* Review the quality of documentation provided at all levels of care to assure adequacy and clinical appropriateness.
* Direct the program services offered, consulting with facility management in the planning, development, implementation and evaluation of the case management program.
* Ensure strategic program goals and objectives are consistent with the overall organization and facility goals and objectives.
* Develop goals, objectives, policies, and procedures related to the operational needs of the program scenarios.
* Develop and maintain a system to minimize and address denials in consult with the facility Business Office Manager and CFO. Assist with managing and writing appeals as indicated.

Employee Management and Staffing

* Maintain and allocate a well-qualified core of staff resources.
* Assist the Director of Clinical Services (DCS) in assuring that hiring, disciplinary actions and termination procedures are conducted in accordance with hospital policies.
* Assure adequate supervision and evaluation processes for all staff members and delegate these responsibilities as appropriate.
* Assist the DCS in assuring that adequate orientation for new employees of the Utilization Management Department.
* Ensure staff scheduling to meet the needs and demands of the patient population and census and adjust it accordingly.
* Ensure an adequate system of communication and reporting is maintained between all staff members, as well as other departments involved in the ongoing operation of the program.
* Work with the DCS to create a structure that best meets the needs of the department, related to supervision and assignment of staff.
* Clinical Leadership
* Assist the DCS in conducting department meetings on a regular basis.
* Work with clinical leadership to ensure interdisciplinary treatment planning is organized with participation of all appropriate clinical disciplines.
* Ensure all patient, family and referral complaints are promptly handled.
* Coordinate the collection of outcome data with the company deadline.

Continuous Quality Improvement

* Work with the DCS to ensure that a system is developed to provide continuity of care and communication with family and appropriate referral sources, and ensure the system is evaluated and reviewed regularly.
* Report denials to the DCS, CEO, and CFO daily.
* Ensure the department meets The Joint Commission, Medicare, federal and state regulatory requirements.
* Work with the DCS to develop and implement a Performance Improvement tracking system, evaluate the results monthly, and report them to the Performance Improvement Committee in a timely manner.
* Ensure all deficiencies identified through the performance improvement analysis are address with appropriate problem solving actions.

Knowledge, Skills, and Abilities

* Knowledge of external review organization (i.e. managed care, Medicare, Medicaid).
* Working knowledge of payer resources and financial planning.
* Demonstrate willingness to acquire knowledge and expertise in complex patient care planning.
* Effective oral and written communication skills.
* Excellent leadership and negotiations skills.
* Excellent customer relations skills.
* Ability to manage conflicting situations.

Qualifications

* Bachelor's degree in Nursing or Master's degree in Social Work, Mental Health/Behavioral Sciences required. Master's Degree preferred.
* A minimum of 3 - 5 years of clinical experience in an inpatient behavioral health hospital required.
* 3 - 5 years of management experience in a related position required.
* Experience with patient assessments, writing appeals, treatment planning, conducting utilization reviews and communication with external review organizations (i.e. managed care, Medicare, Medicaid) or comparable entities required.
* Knowledge of or experience with patients' rights, advanced directives, adult and child abuse laws and emergency detention required.
* A valid license in the State of Michigan as a R.N, or fully licensed MSW required.
* Employees must be in good standing (employment/corrective action history, performance evaluation, etc.) to be considered for internal transfers.

EEO Statement

All UHS subsidiaries are committed to providing an environment of mutual respect where equal employment opportunities are available to all applicants and teammates. UHS subsidiaries are equal opportunity employers and as such, openly support and fully commit to recruitment, selection, placement, promotion and compensation of individuals without regard to race, color, religion, age, sex (including pregnancy, gender identity, and sexual orientation), genetic information, national origin, disability status, protected veteran status or any other characteristic protected by federal, state or local laws.

We believe that diversity and inclusion among our teammates is critical to our success.

Notice

At UHS and all our subsidiaries, our Human Resources departments and recruiters are here to help prospective candidates by matching skillset and experience with the best possible career path at UHS and our subsidiaries. We take pride in creating a highly efficient and best in class candidate experience. During the recruitment process, no recruiter or employee will request financial or personal information (Social Security Number, credit card or bank information, etc.) from you via email. The recruiters will not email you from a public webmail client like Hotmail, Gmail, Yahoo Mail, etc. If you are suspicious of a job posting or job-related email mentioning UHS or its subsidiaries, let us know by contacting us at: https://uhs.alertline.com or 1-800-852-3449.

UHS is a registered trademark of UHS of Delaware, Inc., the management company for Universal Health Services, Inc. and a wholly-owned subsidiary of Universal Health Services, Inc. Universal Health Services, Inc. is a holding company and operates through its subsidiaries including its management company, UHS of Delaware, Inc. All healthcare and management operations are conducted by subsidiaries of Universal Health Services, Inc. To the extent any reference to UHS or UHS facilities on this website including any statements, articles or other publications contained herein relates to our healthcare or management operations it is referring to Universal Health Services' subsidiaries including UHS of Delaware. Further, the terms we, us, our or the company in such context similarly refer to the operations of Universal Health Services' subsidiaries including UHS of Delaware. Any employment referenced in this website is not with Universal Health Services, Inc. but solely with one of its subsidiaries including but not limited to UHS of Delaware, Inc.

UHS is not accepting unsolicited assistance from search firms for this employment opportunity. Please, no phone calls or emails. All resumes submitted by search firms to any employee at UHS via- email, the Internet or in any form and/or method without a valid written search agreement in place for this position will be deemed the sole property of UHS. No fee will be paid in the event the candidate is hired by UHS as a result of the referral or through other means.