Utilization Review Manager

At ERC Pathlight, we’re on a mission to change lives—and we’re looking for people who feel called to do the same.

As one of the nation’s leading treatment providers for eating disorders and mood, anxiety, and trauma-related conditions, we bring innovative, evidence-based, and deeply compassionate care to patients across the country. With multiple locations nationwide and extensive virtual programming, we meet patients exactly where they are and help them move toward lasting recovery.

Founded in 2008 by renowned psychiatrists and psychologists, ERC Pathlight now supports more than 6,000 patients each year. And as the need for world-class mental health care continues to rise, our commitment is stronger than ever: to expand access, elevate the standard of care, and empower every patient to rebuild their life with dignity and hope.

As a Manager, Utilization Review, you will hire, evaluate, and supervise Utilization Review Specialists and oversee Utilization Review operations. This role coordinates with Clinical Managers and Directors, Physicians, Business Office, and Managed Care Organizations to assure the smooth operation of Utilization Review functions and the provision of optimal patient care.

• →Clinically supervises teammates in 1:1 and group settings; provides in-moment assistance on escalated issues. Provides oversight to assigned team by supervising, guiding, and directing employees to be effective team members. Ensures that everyone is equipped with the right skills, tools, and talents necessary for executing their duties. Using the established people processes (performance, development, succession, and career) to ensure that the team’s level of performance and capabilities meet current and future standards.
• →Advocates for optimal patient care in clinical care determination reviews by proactively reviewing and synthesizing the medical record for discussion with licensed mental health counselors and social workers and RNs at managed care organizations
• →Liaison with regional management teams to discuss clinical issues and facilitate solutions to situations that involve the UR process
• →Oversees regional caseload allocation
• →Attends treatment team meetings to share information and represent UR department; shares clinical documentation quality concerns

• Graduate Degree  - Master's degree in psychology, counseling or social work. Alternatively, a bachelor's in Nursing

• RN, IF nurse (Required)
• Full clinical licensure, if mental health. (Required)

• 4 to 6 years Utilization review experience (Required)
• 2 years post-degree mental health experience in direct patient care (Required)
• 2 years management experience (Preferred)
• Willingness to work occasional night/weekends

• Remote: Mondays and Fridays
• On-site in our Denver Office: Tuesdays, Wednesdays, and Thursdays