Director of Utilization (100 onsite)

Starlite Recovery Center has an opportunity to hire a Director of Utilization to join their Amazing Team!

Starlite Recovery Center has been treating individuals with Substance Use Disorder for over 67 years. Starlite Recovery Center is located in the Hill Country southeast of Kerrville and approximately 30 minutes northwest of Boerne Texas.

PURPOSE STATEMENT:

Direct and manage the day-to-day 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.

OTHER FUNCTIONS:

• Perform other functions and tasks as assigned.

EDUCATION/EXPERIENCE/SKILL REQUIREMENTS:

• Bachelors Degree in nursing or other clinical field . 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 .
• Three or more years of supervisoryexperience .

LICENSES/DESIGNATIONS/CERTIFICATIONS:

• If applicable current licensure as an LPN or RN within the state where the facility provides services; or current clinical professional license or certification as within the state where the facility provides services.

We are committed toprovidingequalemploymentopportunitiestoall applicantsforemploymentregardlessofanindividualscharacteristicsprotected byapplicable statefederalandlocallaws.