Director-Utilization Management Position Available In St. John the Baptist, Louisiana
Tallo's Job Summary: Join River Place Behavioral Health as a Utilization Management Director. Manage daily operations, conduct reviews, and collaborate with staff to optimize patient care. Requirements include a Bachelor's Degree in nursing or clinical field, 6+ years of clinical experience, and 4+ years in utilization management. LPN or RN licensure required. Equal Opportunity Employer.
Job Description
Director-Utilization Management 2.9 2.9 out of 5 stars 500 Rue De Sante, Laplace, LA 70068 Come join our team as a Utilization Management Director at River Place Behavioral Health! If you are a positive, empathetic, and passionate person and are dedicated to making a difference in the lives of those in need while working in a team environment that supports learning and growth, this position is right for you! River Place Behavioral Health, a service of Ochsner Health System, provides state-of-the-art psychiatric care for adults who are struggling with depression, anxiety, bipolar disorder, and other mental health concerns.
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 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.
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
Current licensure as an LPN or RN or current clinical professional license or certification in the state of LA. Education Preferred Bachelors or better Associates or better Licenses & Certifications Preferred Lic Practical Nurse Reg Nurse Lic Social Worker Equal Opportunity Employer This employer is required to notify all applicants of their rights pursuant to federal employment laws. For further information, please review the Know Your Rights notice from the Department of Labor.
