Director of Utilization

1 day ago

New Port Richey, Florida, United States North Port Behavioral Health Full time

North Port Behavioral Health in North Port, FL is seeking a Full Time Director of Utilizatioin at our newly opened facility.
Purpose Statement
Direct and manage the day-to-day operations of the Utilization Review department.

As part of Acadia Healthcare we are 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.

Essential Functions

  • 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.

Other Functions

  • Perform other functions and tasks as assigned.

Education/Experience/Skill Requirements

  • Bachelor's Degree in nursing or other clinical field required. Master's Degree in clinical field preferred.
  • Six or more year's clinical experience with the population of the facility preferred.
  • Four or more years' experience in utilization management required.
  • Three or more years of supervisory experience required.

Licenses/Designations/Certifications

  • 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.

We are committed to providing equal employment opportunities to all applicants for employment regardless of an individual's characteristics protected by applicable state, federal and local laws.

NPORT

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