ARKANSAS CHILDREN'S IS A TOBACCO FREE WORKPLACE. FLU VACCINES ARE REQUIRED. ARKANSAS CHILDREN'S IS AN EQUAL OPPORTUNITY EMPLOYER. ALL QUALIFIED APPLICANTS WILL RECEIVE CONSIDERATION FOR EMPLOYMENT WITHOUT REGARD TO RACE, COLOR, RELIGION, SEX, SEXUAL ORIENTATION, GENDER IDENTITY OR EXPRESSION, NATIONAL ORIGIN, AGE, DISABILITY, PROTECTED VETERAN STATUS OR ANY OTHER CHARACTERISTIC PROTECTED BY FEDERAL, STATE, OR LOCAL LAWS.
This position has been designated as safety sensitive and cannot be filled by a candidate who is a current user of medical marijuana.
CURRENT EMPLOYEES: Please apply via the internal career site by logging into your Workday Account (https://www.myworkday.com/archildrens/)and search the "Find Jobs" report.
Work Shift:
Day Shift
Time Type:
Full time
Department:
CC017217 Children's Specialty ServicesArkansas Children's Behavioral Health, FT, M-F, 8a-5p
The Utilization Manager improves overall quality of clinical documentation to ensure that information in the medical record accurately reflects client's care and progress, and thus utilization of resources. This role works with providers to correctly capture that services being delivered are medically necessary and timely.
RN or LPC Required
Masters Degree Required
3 years in Mental Health/ Hospital Setting
Master's degree in a related field of study.
Master's degree in a related field of study., Master's Degree Nursing
1 of the following certifications is required -
Licensed Certified Social Worker (LCSW) - Arkansas Professional Board, Licensed Professional Counselor (LPC) - Arkansas Board of Examiners in Counseling, RN License (AR or Compact State) - Arkansas State Board of Nursing (ASBN)1. Complete concurrent and retrospective medical record reviews to ensure services are appropriate, efficient, and compliant with payer and regulatory guidelines.2. Process pre-authorizations and requests for services that are medically necessary and adherent to payer rules.3. Consult with multidisciplinary team members regarding patient diagnosis, medical justification, length of treatment, and case documentation.4. Represents the clinical and administrative team with payers for any appeals or disagreements related to care plans.5. Provide training and education about utilization requirements to clinical and supervisory staff.6. Demonstrate competency on mental health symptomology, treatment options and efficacies, and impact of trauma and mental health on overall well-being.7. Participate in quality or accreditation audits to ensure program compliance on utilization review regulations.8. Completes clinical supervision and staffing to clinicians completing their required supervision hours for full licensure, if necessary.9. Knowledge of regulatory requirements and Arkansas laws governing services to children, adolescent and adults preferred.10. Other duties as assigned.
Arkansas Children's is the only healthcare system in the state solely dedicated to caring for Arkansas' more than 700,000 children. The private, non-profit organization includes two pediatric hospitals, a pediatric research institute and USDA nutrition center, a philanthropic foundation, a nursery alliance, statewide clinics, and many education and outreach programs — all focused on fulfilling a promise to define and deliver unprecedented child health. Arkansas Children’s Hospital (ACH) is a 336-bed, Magnet-recognized facility in Little Rock operating the state’s only Level I pediatric trauma center; the state's only burn center; the state's only Level IV neonatal intensive care unit; the state's only pediatric intensive care unit; the state’s only pediatric surgery program with Level 1 verification from the American College of Surgeons (ACS); the state’s only magnetoencephalography (MEG) system for neurosurgical planning and cutting-edge research; and the state's only nationally recognized pediatric transport program. Arkansas Children’s Hospital is nationally ranked by U.S. News & World Report in seven pediatric specialties (2022—2023): Cancer, Cardiology & Heart Surgery, Diabetes & Endocrinology, Nephrology, Neurology & Neurosurgery, Pulmonology and Urology. Arkansas Children’s Northwest (ACNW), the first and only pediatric hospital in the Northwest Arkansas region, is a level IV pediatric trauma center. ACNW operates a 24-bed inpatient unit; a surgical unit with five operating rooms; outpatient clinics offering over 20 subspecialties; diagnostic services; imaging capabilities; occupational therapy services; and Northwest Arkansas' only pediatric emergency department, equipped with 30 exam rooms. Generous philanthropic and volunteer engagement has sustained Arkansas Children's since it began as an orphanage in 1912, and today ensures the system can deliver on its promise of unprecedented child health. To learn more, visit archildrens.org.
