Manager - Utilization

Acadia Healthcare • Henderson, NV

10d

About The Position

The Manager - Utilization monitors utilization of services and optimizes facility reimbursement while maximizing the use of patients’ provider benefits to meet their needs. The role provides guidance on admissions and length of stay, obtains and maintains insurance authorizations, evaluates utilization-program compliance, reviews documentation for denied stays, and manages department staff.

Requirements

• If applicable, hold a current LPN or RN license in the state where the facility provides services, or hold a current clinical professional license or certification required in that state.
• CPR certification is required; training is available upon hire and offered by the facility.
• De-escalation and restraint certification is required; training is available upon hire and offered by the facility.
• First aid may be required based on state or facility requirements.

Responsibilities

• Provide consultation and guidance to a variety of payers regarding admissions and patient length of stay.
• Secure authorizations from insurance companies for inpatient treatment and obtain continued authorizations for the duration of each patient’s stay.
• Evaluate the utilization program for compliance with regulations, policies, and procedures.
• Review clinical documentation from denied stays against criteria to determine whether documentation supports the requested treatment.
• Manage staff, including hiring, development, training, performance management, and communication, to ensure effective and efficient department operations.
• Perform other functions and tasks as assigned.

What This Job Offers

• Job Type: Full-time
• Career Level: Manager
• Education Level: No Education Listed