Director of Utilization Onsite

Overview

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.

PURPOSE STATEMENT:

Direct and manage the day-to-day operations of the Utilization Review department .

Responsibilities

ESSENTIAL FUNCTIONS:

• Monitor utilization of services and optimize reimbursement for the facility while maximizing use of the patients 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.

OTHER FUNCTIONS:

• Perform other functions and tasks as assigned.

Qualifications

EDUCATION/EXPERIENCE/SKILL REQUIREMENTS:

• Bachelors Degree in nursing or other clinical field . Masters Degree in clinical field preferred.
• Six or more years clinical experience with the population of the facility preferred.
• F our or more years experience in utilization management .
• Three or more years of supervisoryexperience .

LICENSES/DESIGNATIONS/CERTIFICATIONS:

• 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.

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

AHCORP

#LI-SLRC

Required Experience:

Director