Strategic Director of Utilization & Care Optimization

Starlite Recovery Center; Boerne (TX); Sur place; USD 110 000 - 150 000; Plein temps

Résumé du poste

Starlite Recovery Center is seeking a Director of Utilization to lead the Utilization Review department at its Center Point location in the Hill Country, southeast of Kerrville and near Boerne, Texas. The role directs day-to-day operations and collaborates with clinical staff to optimize patient care and reimbursement.

The ideal candidate will have a nursing or clinical background with 6+ years of clinical experience, 4+ years in utilization management, and 3+ years of supervisory experience.

Qualifications

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

Responsabilités

• Direct and manage the day-to-day operations of the Utilization Review department.
• Monitor utilization of services and optimize reimbursement for the facility while maximizing use of the patient's provider benefits for their needs.
• Conduct concurrent and retrospective reviews for all patients.
• Act as a liaison between Medicaid reviewers and staff completing required paperwork to facilitate the Utilization Review process.
• Collaborate with physicians, therapists and nursing staff to provide optimal review based on patient needs.
• Collaborate with ancillary services to prevent delays in services.
• Evaluate the UM program for compliance with regulations, policies and procedures.
• May review charts and make recommendations to physicians regarding utilization review and managed care issues.
• Provide staff management including hiring, development, training, performance management and communication to ensure effective and efficient department operation.

Connaissances

Leadership

Team Management

Regulatory Knowledge

Utilization Management

Formation

Bachelor's Degree in nursing or other clinical field

Master's Degree in clinical field

Outils

RN/LPN licensure

Description du poste

Starlite Recovery Center is seeking a Director of Utilization to lead the Utilization Review department at its Center Point location in the Hill Country, southeast of Kerrville and near Boerne, Texas. The role directs day-to-day operations and collaborates with clinical staff to optimize patient care and reimbursement.

The ideal candidate will have a nursing or clinical background with 6+ years of clinical experience, 4+ years in utilization management, and 3+ years of supervisory experience.