Director of Utilization Review & Care Optimization

La Amistad Behavioral Health Services; Town of Florida (NY); On-site; USD 120,000 - 180,000; Full time

Benefits offered by this job

Competitive Compensation

Growth and Development Opportunities (

Excellent Medical, Dental, Vision and

Job summary

La Amistad Behavioral Health Services is seeking a Director Of Utilization Review to lead the utilization review process, supervise staff, and ensure high-quality patient care in a cost-effective manner.

The role requires coordinating with physicians and social services, maintaining data for leadership, and ensuring compliance with Joint Commission, Medicare, and regulatory requirements. Strong leadership and budget management are essential.

Qualifications

• Bachelor’s degree in psychology or related field, or RN licensure.
• 3–5 years’ experience in chart analysis and utilization review in psychiatric and chemical dependency field preferred.
• Good oral and written communication skills required to communicate with patients, physicians, staff and administration.

Responsibilities

• Direct the utilization review process and supervise Utilization Review staff.
• Coordinate with physicians and the Social Services department to ensure quality documentation of patient care.
• Identify Utilization Review problems and maintain data for use by leadership.
• Review the quality of documentation at all levels of care to ensure adequacy and clinical appropriateness.
• Ensure patients receive effective and appropriate treatment and monitor outcomes.

Skills

Communication skills

Education

Bachelor’s degree in psychology or related field; RN licensure

Job description

La Amistad Behavioral Health Services is seeking a Director Of Utilization Review to lead the utilization review process, supervise staff, and ensure high-quality patient care in a cost-effective manner.

The role requires coordinating with physicians and social services, maintaining data for leadership, and ensuring compliance with Joint Commission, Medicare, and regulatory requirements. Strong leadership and budget management are essential.