Director of Utilization

Acadia Healthcare • Malden, MA

5d • Onsite

About The Position

Acadia Healthcare is a leading provider of behavioral healthcare services across the United States. Acadia operates a growing network of 250 plus behavioral healthcare facilities with approximately 11,100 beds in 39 states and Puerto Rico. With more than 23,000 employees serving approximately 75,000 patients daily, Acadia is the largest stand-alone behavioral health company in the U.S. Acadia Healthcare’s purpose is to Lead Care With Light and our mission is to be a world-class organization that sets the standard for excellence in the treatment of mental health and addiction concerns. We strive to maintain our standing as a thought leader in the behavioral healthcare industry, providing treatment that is synonymous with compassion and innovation. ONSITE Director of Utilization – Tufts Medicine Behavioral Health Hospital Tufts Medicine, a leading integrated academic health system in Massachusetts, and Acadia Healthcare, the largest standalone provider of behavioral health services in the U.S., have partnered to create the Tufts Medicine Behavioral Health Hospital, a state-of-the-art, 144-bed facility in Malden, Massachusetts. Slated to open in early 2026, this hospital is designed to address the growing need for high-quality behavioral health services in the region. The Tufts Medicine Behavioral Health Hospital will serve as a center of excellence, offering inpatient and intensive outpatient programs for patients of all ages. Additionally, it will function as a teaching hospital, providing a vital training site for future behavioral health professionals, including students and residents from the Tufts University School of Medicine. This initiative aims to address the regional shortage of behavioral health clinicians while ensuring a continuum of care for patients and their families. The Director of Utilization will d irect and manage the day-to-day operations of the Utilization Review department .

Requirements

• Bachelor's Degree in nursing or other clinical field .
• Six or more year's clinical experience with the population of the facility preferred.
• F our or more years ’ experience in utilization management .
• Three or more years of supervisory experience .
• If applicable, c urrent licensure as an LPN or RN within the state where the facility provides services; or current clinical professional license or certification, as , within the state where the facility provides services.

Nice To Haves

• Master's Degree in clinical field preferred.

Responsibilities

• 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 review s 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.

What This Job Offers

• Job Type: Full-time
• Career Level: Manager
• Number of Employees: 5,001-10,000 employees