What are the responsibilities and job description for the Director of Utilization position at TrustPoint Hospital?
Join our team at TrustPoint Hospital as a Director of Utilization! We are seeking passionate professionals that are dedicated to behavioral health. If you are looking for unparalleled growth opportunities and are wanting to make a meaningful impact in your community, this is the position for you! TrustPoint Hospital is a 217-bed, state-of-the-art treatment center providing comprehensive medical and psychiatric services on both inpatient and outpatient bases. We deliver exceptional care to patients needing acute physical medicine and rehabilitation, adult, adolescent, geriatric psychiatry, and medical psychiatry.
TrustPoint Hospital offers an extensive array of benefits to our valued team members. Current offerings encompass:
Direct and manage the day-to-day operations of the Utilization Review department.
Essential Functions
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TrustPoint Hospital 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
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.
- Perform other functions and tasks as assigned.
- 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.
- 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.
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