Manager, PRM Behavioral Health (FT) 8a-5p, Ridgeview - Bristol, TN

SCOPE OF POSITION
The Manager, PRM Behavioral Health provides oversight of Patient Resource Management, Utilization Review, Pre-Certification and Denials management for Behavioral Health.  This individual will work closely with the Associate Administrator, Clinical Program Director, Managers, and Medical Staff to ensure appropriate utilization of patient resources and timely movement of patients throughout the Behavioral Health continuum of care.  The Behavioral Health, Patient Resource Manager is respectively responsible for all departmental activities including policies, processes and procedures, and supervision of the personnel in the above stated units and is responsible for utilization management program development, denials management, and performance improvement.

The individual must have extensive knowledge of insurance reimbursement, payer contracts, case management, utilization management, discharge planning, and clinical outcomes management.  The Behavioral Health, Patient Resource Manager will participate in budgetary process, be held accountable for proper utilization of personnel and material resources in accordance with budget and will be responsible for recruiting, hiring, onboarding and retaining staff.

The Behavioral Health, Patient Resource Manager will work closely with the Behavioral Health Clinical Program Manager to coordinate staffing needs and clinical programing. This individual will be facilitating new treatment programs and services to meet patient needs to align with the strategic plan for the organization by working with community resources, as appropriate to ensure patient needs are met.

REPORTING RELATIONSHIP
See Table of Organization.

EDUCATION AND EXPERIENCE​
Bachelor's degree in Business, Nursing, Psychology, Social Work, or related healthcare field required, Master's degree preferred. Significant clinical and management training experience required. Minimum five years experience in healthcare, preferably two years of which are in a mental health setting. Previous Patient Resource Management and Utilization Review experience is preferred.
 

Valid and active RN licensure or Social Work licensure in appropriate state preferred (if nursing or social work degree is obtained)
CPR required