Director-Utilization Management
Director-Utilization Management
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Salary Not Disclosed
1 Vacancy
Job Description
Come join our team as a Utilization Management Director at River Place Behavioral Health! If you are a positive empathetic and passionate person and are dedicated to making a difference in the lives of those in need while working in a team environment that supports learning and growth this position is right for you!
River Place Behavioral Health a service of Ochsner Health System provides stateoftheart psychiatric care for adults who are struggling with depression anxiety bipolar disorder and other mental health concerns.
PURPOSE STATEMENT:
Direct and manage the daytoday operations of the Utilization Review department.
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 reviews 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.
EDUCATION/EXPERIENCE/SKILL REQUIREMENTS:
- Bachelors Degree in nursing or other clinical field required. Masters Degree in clinical field preferred.
- Six or more years clinical experience with the population of the facility preferred.
- Four or more years experience in utilization management required.
- Three or more years of supervisoryexperience required.
LICENSES/DESIGNATIONS/CERTIFICATIONS:
- Current licensure as an LPN or RN or current clinical professional license or certification in the state of LA.
Required Experience:
Director
Employment Type
Full-Time
