Full time, Full Time
UNC Health
Hendersonville, NC
Job Description
Description Your passion belongs at UNC Health. Join more than 56,000 teammates working together to improve the health and well-being of the communities we serve across North Carolina. Summary: The Utilization Manager (UM) reviews admissions, continued stays, and discharges for medical necessity and the appropriate class and level of care (LOC). The UM works with physicians, nursing, care managers, social workers, payers, and LME/MCOs so that patient needs are met and care is coordinated. All reviews follow federal and state regulations and UNC Health Pardee's Utilization Review Plan. Assignments are made by Care Management leadership based on licensure and validated competency. RN-licensed UMs may be assigned to any patient population. LCSW- and LCMHC-licensed UMs are assigned to patients whose primary reason for hospitalization or continued stay is a behavioral health condition. The UM conducts initial...