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West Pines Behavioral Health

Director of Utilization Review

West Pines Behavioral Health, Westminster, Colorado, United States, 80031


West Pines Behavioral Hospital

is a

new

144-bed inpatient behavioral health facility serving Denver area residents located at 11455 Huron Street, Westminster, CO. A joint venture between Intermountain Health and Acadia Healthcare. The hospital will provide comprehensive inpatient and intensive outpatient services to address the growing need for accessible, high-quality behavioral health care in the Denver metro area with an opening date of December 2024.

We are seeking passionate people with a caring attitude. Apply today!!!

Responsibilities: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.

Conduct and oversee 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.

Collaborate with physicians, therapists, and nursing staff to provide optimal review based on patient needs.

Collaborate with ancillary services in order to prevent delays in services.

Evaluate the UM program for compliance with regulations, policies, and procedures.

Review charts and make necessary recommendations to the physicians regarding utilization review and specific managed care issues.

Provide staff management 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 required.

Six or more years of clinical experience with the population of the facility preferred.

Four or more years of 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 Colorado.

BENEFITS:

Health insurance

Dental Insurance

Vision Insurance

Flexible Spending Account/Health Savings Account

Retirement plan with 401k match

Tuition reimbursement

Paid sick leave & Extended sick leave

SALARY RANGE:

$69,672 - $104,508

We are committed to providing equal employment opportunities to all applicants for employment regardless of an individual’s characteristics protected by applicable state, federal, and local laws.

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