Director of Utilization Management

Starlite Recovery Center; Boerne (TX); On-site; USD 120,000 - 160,000; Full time

Job summary

Starlite Recovery Center in Center Point, Texas, seeks a Director of Utilization to lead the Utilization Review department. The role focuses on directing day-to-day operations, optimizing reimbursement, and ensuring compliant review processes in collaboration with medical and support staff.

QUALIFICATIONS include a nursing or clinical field degree, an RN license, and at least four years in utilization management with supervisory experience.

Qualifications

• Bachelor's degree in nursing or a clinical field is required.
• Six+ years of clinical experience with the facility's population preferred.
• Four+ years in utilization management required.
• Three+ years of supervisory experience required.

Responsibilities

• Monitor utilization of services and optimize reimbursement for the facility.
• Conduct concurrent and retrospective reviews for all patients.
• Act as liaison between Medicaid reviewers and staff for required paperwork.
• Collaborate with physicians, therapists and nursing staff for optimal reviews.
• Coordinate with ancillary services to prevent delays in services.
• Evaluate the UM program for regulatory compliance.
• Provide staff management including hiring, development, training and performance management.
• Perform other tasks as assigned.

Skills

Clinical experience

Utilization management

Supervisory experience

Education

Bachelor's degree in nursing or other clinical field

Master's degree in clinical field preferred

RN license or equivalent

Job description

Starlite Recovery Center in Center Point, Texas, seeks a Director of Utilization to lead the Utilization Review department. The role focuses on directing day-to-day operations, optimizing reimbursement, and ensuring compliant review processes in collaboration with medical and support staff.

QUALIFICATIONS include a nursing or clinical field degree, an RN license, and at least four years in utilization management with supervisory experience.