The Company
Sana Lake Recovery; is a uniquely different addiction and mental health treatment center from the vast majority of centers in the country as we solely focus on delivering better outcomes for our members measured in terms of quality of life. Our system of care models the addiction programs for physicians and airline pilots which have achieved materially better outcomes than the typical treatment center over a long period of time. Our staff deliver highly personalized care using dynamic treatment and recovery plans managed by specialized care coordinators. Treatment is holistic evidence-based across a full continuum of care, from acute to chronic care programming with extended care support for five years or more. Programming is delivered by professionally credentialed medical, therapeutic, clinical and peer specialist staff. Frequent assessments are conducted of the members’ progress of achieving goals they can reasonably attain to adjust the treatment plan as needed. The staff are highly trained and credentialed professionals that care about the member finding recovery for life in everything we do.
Our facilities, from medically monitored detox to residential, outpatient, recovery supportive housing and transportation, are warm, calming and comfortable for optimal healing and recovery. Many describe our facilities as world-class, but however they may be described, it is a healing environment that engenders longer term connections with a community of like-minded people who first come into treatment not wanting to be there, who find our facilities to be where they want to be.
Our acute care detox and residential facility is strategically located on a stunning, serene and private 55 acres just west of St. Louis, MO. We offer the only dedicated 24/7 medically monitored and staffed detox unit of its kind in the region. Urgent access to medical, psychiatric and behavioral assessments and outpatient services are housed in modern state-of-the-art Behavioral Wellness Centers in St. Louis and Kansas City, Missouri. Our recovery supportive housing is located in safe neighborhoods in St. Louis with one- and two-bedroom multi-family units with 24/7 staff supervision and transportation provided for Behavioral Wellness and other recovery supportive services.
As amazing as our properties and programming might be, the most important part of Sana Lake is our staff. We are blessed to have people at all levels in the organization who are deeply passionate about helping others find recovery for life. This passion cannot be manufactured. It happens every day in many small unknown actions when a staff member goes above and beyond to connect with the member, or in big ways where a life is saved. Staff have the freedom to do what they believe our members need to achieve their treatment and recovery goals. Freedom is an amazing gift that we cherish and earn every day.
-Paul D. Melnuk, CEO-
Role and Responsibilities
Job Overview: To provide services for dedicated managed care accounts and members; to ensure the efficient, cost effective, and high quality delivery of utilization management/review service by supervising and assisting in mentoring a team of utilization reviewers; to oversee the management of disbursement of cases; to oversee individual and overall results/outcomes of all cases within their scope of responsibilities; and to ensure customer satisfaction through the provision of cost effective and high quality utilization review service that meets their needs.
- Strong communication, problem solving, organizational and monitoring progress towards goals of the team.
- Responsible for examining the spreadsheets to ensure that Utilization Reviewers are conducting reviews in a timely manner.
- Serves as point person in assisting with questions from the UR team.
- Accountable for assigning out caseloads to Reviewers in an equal manner.
- Liaison between departments and UR when information is missing from charts in KIPU.
- Ability to delegate.
- Resilient organizational skills with multi-tasking ability.
- Responsible for a small 3–5-member caseload for difficult cases.
- Reporting findings in weekly meeting to UR Director for data analysis.
- Participates in the scheduling of training for UR reviewers that is conducted by UR Director.
- Can conduct Peer Reviews on an as needed basis in the event of staffing and scheduling conflicts.
- Attends weekly staff meetings per schedule.
- Adheres to facility policies and procedures, Missouri DBH standards, and Joint Commission standards.
- Performs other duties assigned.
Qualifications and Education Requirements
- Masters Level Degree, preferred
- State licensure (Registered Nurse, Licensed Practical Nurse, Licensed Clinical Social Worker, Licensed Mental Health Counselor, or other healthcare license), required.
- Minimum of three to five years’ experience working in a behavioral health care setting, with a minimum of three years of utilization review experience.
Preferred Skills
- Demonstrates Proficiency in Communication & Written skills.
- Knowledge of State & Federal Statutes Regarding Patient Confidentiality laws.
- Knowledge of Drug-Free Workplace Policies.
- Knowledge of Workplace Violence.
- Knowledge of Corporate Integrity & Compliance Program.