On-Site Director of Utilization & Care Optimization

Acadia Healthcare; Kennett Square (Chester County); On-site; USD 90,000 - 140,000; Full time

Benefits offered by this job

Medical, Dental, Vision Insurance

HSA and FSA options

Company-paid Life & AD&D insurance

Disability benefits

401(k) with company match

EAP and Employee Discount Program

Paid Holidays

PTO

Tuition Reimbursement

Job summary

Bowling Green Inn at Brandywine in Kennett Square, PA seeks a Director of Utilization to lead the Utilization Review department on-site. You will oversee concurrent and retrospective reviews, coordinate with Medicaid reviewers, and work with physicians, therapists, and nursing staff to ensure appropriate patient utilization and reimbursement strategies.

The role requires clinical leadership with 4+ years in utilization management, supervisory experience, and a relevant nursing/clinical degree.

Qualifications

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

Responsibilities

• Monitor utilization of services and optimize reimbursement for the facility while ensuring appropriate patient benefit usage.
• Conduct concurrent and retrospective reviews for all patients.
• Act as liaison between Medicaid reviewers and staff to facilitate Utilization Review.
• Collaborates with physicians, therapists and nursing staff to provide optimal review based on patient needs.
• Collaborates with ancillary services to prevent delays in services.
• Evaluate the UM program for compliance with regulations, policies and procedures.
• Provide staff management including hiring, development, training and performance management.

Skills

Utilization management

Supervisory experience

Education

Bachelor's Degree in nursing or clinical field

Master's Degree in clinical field

Job description

Bowling Green Inn at Brandywine in Kennett Square, PA seeks a Director of Utilization to lead the Utilization Review department on-site. You will oversee concurrent and retrospective reviews, coordinate with Medicaid reviewers, and work with physicians, therapists, and nursing staff to ensure appropriate patient utilization and reimbursement strategies.

The role requires clinical leadership with 4+ years in utilization management, supervisory experience, and a relevant nursing/clinical degree.