Director of Utilization (100% onsite)

Boerne, TX•Boerne, TX

12d•Onsite

About The Position

Starlite Recovery Center has an opportunity to hire a Director of Utilization to join their Amazing Team! This opportunity is located at Starlite Recovery Center in Center Point, the Hill Country, southeast of Kerrville, and approximately 30 minutes northwest of Boerne, Texas. Starlite Recovery Center has been treating individuals with Substance Use Disorder for over 67 years.

Requirements

Bachelor's Degree in nursing or other clinical field required.
Four or more years’ experience in utilization management required.
Three or more years of supervisory experience required.
If applicable, current licensure as an LPN or RN within the state where the facility provides services; or current clinical professional license or certification, as required, within the state where the facility provides services.

Nice To Haves

Master's Degree in clinical field preferred.
Six or more year's clinical experience with the population of the facility preferred.

Responsibilities

Direct and manage the day-to-day operations of the Utilization Review department.
Monitor utilization of services and optimize reimbursement for the facility while maximizing use of the patient’s provider benefits for their needs.
Conducts and oversees concurrent and retrospective reviews for all patients.
Act as a liaison between Medicaid reviewers and the staff completing required paperwork to facilitate the Utilization Review process.
Collaborates with physicians, therapist and nursing staff to provide optimal review based on patient needs.
Collaborates with ancillary services in order to prevent delays in services.
Evaluates the UM program for compliance with regulations, policies and procedures.
May review charts and make necessary recommendations to the physicians, regarding utilization review and specific managed care issues.
Provide staff management to including hiring, development, training, performance management and communication to ensure effective and efficient department operation.
Perform other functions and tasks as assigned.