OverviewBowling Green Inn at Brandywine is seeking a Director of Utilization to join our team!
100% On-site role in Kennett Square, PA
Located in the scenic and historic countryside of Pennsylvania’s Brandywine River Valley, Bowling Green Inn at Brandywine has been a premier provider of effective chemical dependency treatment for more than 30 years. Bowling Green Brandywine is a 200-bed Alcohol and Drug Rehab Treatment Center in Kennett Square, PA.
Bowling Green Inn at Brandywine offers an extensive array of benefits to our valued team members. Current offerings encompass:
- Medical, Dental, and Vision Insurance coverage
- Health Savings Account (HSA) and Flexible Spending Account (FSA) options
- Company-paid Basic Life & AD&D insurance
- Disability benefits
- 401(k) Retirement Plan with a company match
- Employee Assistance Program (EAP) and Employee Discount Program
- Paid Holidays for work-life balance
- Paid Time Off (PTO)
- Tuition Reimbursement opportunities for career advancement
PURPOSE STATEMENT:
Direct and manage the day-to-day operations of the Utilization Review department.
Schedule: on site; Monday - Friday with weekend availability
Responsibilities
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.
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.
AHCORP
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