Director-Utilization Management

Acadia Healthcare • bloomfield, mi, us • 2m ago

Description

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.

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