Director of Utilization

Apply Now

Company: West Pines Behavioral Health

Location: Westminster, CO 80031

Description:

Overview

West Pines Behavioral Hospital is a new 144-bed inpatient behavioral health facility serving Denver area residents located at 11455 Huron Street, Westminster, CO. A joint venture between Intermountain Health and Acadia Healthcare. The hospital will provide comprehensive inpatient and intensive outpatient services to address the growing need for accessible, high-quality behavioral health care in the Denver metro area with an opening date of December 2024.

We are seeking passionate people with a caring attitude. Apply today!!!

Responsibilities

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 patient's 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.


BENEFITS:
  • Health insurance
  • Dental Insurance
  • Vision Insurance
  • Flexible Spending Account/Health Savings Account
  • Retirement plan with 401k match
  • Tuition reimbursement
  • Paid sick leave & Extended sick leave


Salary range: $69,672 - $104,508

Qualifications

EDUCATION/EXPERIENCE/SKILL REQUIREMENTS:
  • Bachelor's Degree in nursing or other clinical field required. Master's Degree in clinical field preferred.
  • Six or more year's clinical experience with the population of the facility preferred.
  • Four or more years' experience in utilization management required.
  • Three or more years of supervisory experience required.

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 required, within the state where the facility provides services.


We are committed to providing equal employment opportunities to all applicants for employment regardless of an individual's characteristics protected by applicable state, federal and local laws.

Similar Jobs