Interim--Director of Utilization

Acadia Healthcare • Springdale, AR

11d

About The Position

PURPOSE STATEMENT: Direct 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: Director
• Number of Employees: 5,001-10,000 employees