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Director of Utilization Review in Columbus, OH at Acadia Healthcare

Date Posted: 11/26/2018

Job Snapshot

  • Employee Type:
    Full-Time
  • Location:
    Columbus, OH
  • Experience:
    At least 6 year(s)
  • Date Posted:
    11/26/2018

Job Description

Overview

            Utilization Review Director

Mount Carmel Health System and Acadia Healthcare announced a joint venture agreement to develop a $26 million behavioral health hospital in Columbus. The new hospital will replace the current 20-bed inpatient psychiatric unit at Mount Carmel West with a freestanding 80-bed inpatient behavioral health hospital, quadrupling Mount Carmel's current capacity for inpatient mental health services.

The 64,300-square-foot behavioral health hospital will include three permanent units—geriatric, adult and dual diagnosis. A fourth unit will flex, based on specific community needs. Additional features include an activity therapy center and gymnasium, an outpatient therapy center, an electroconvulsive therapy center (ECT) and outdoor activity yards. It's expected to open late 2018.

Responsibilities
  • Monitor utilization of services and optimize reimbursement for the facility while maximizing use of the patient’s provider benefits for their needs. 
  • Responsible for the concurrent and retrospective reviews for all patients. 
  • Act as a liaison between Medicaid reviewers/gatekeepers and the staff completing required paperwork to facilitate the Utilization Review process. 
  • Work with physicians, therapist and nursing staff to provide optimal review based on patient needs. 
  • Work with ancillary services in order to prevent delays in services. 
  • May review charts and make necessary recommendations to the physicians, regarding utilization review and specific managed care issues. 
  • Provide oversight and direction to utilization staff.

Job Requirements

  • Bachelor's Degree in nursing or other clinical field. Master's Degree in clinical field preferred. Six or more year's clinical experience with the population of the facility, previous experience in utilization management preferred. 

  • Three or more years of supervisory experience required.

  • 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.

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