Quality Management Director - Healthcare jobs in Tampa, FL

Come join our team as the Director of Utilization Management, at North Tampa Behavioral Health! If you are passionate and dedicated to making a difference in the lives of those in need through compassionate therapeutic practices, this position is right for you!

North Tampa Behavioral Health is the leading treatment program for individuals suffering with mental health & substance abuse issues. Our expert staff restore hope and provide lasting recovery to adults in the greater Tampa area, through holistic care and comprehensive inpatient & outpatient programs, including a separate inpatient program for senior adults. Our inpatient program also features specialized tracks for co-occurring disorders and chemical dependency. North Tampa Behavioral Health is conveniently located less the 20 miles from downtown Tampa, Florida, in beautiful Wesley Chapel, right off I-75 on SR-56. Our employees describe working at North Tampa Behavioral Health as “being part of a family”, “ability to make a real difference in a person’s life”, “warm and welcoming”, “providing service to those in need”. Our employees feel they make a difference in each patient they treat. Learn more at www.northtampabehavioralhealth.com.

We currently have an opening for a Full time, Director of Utilization Management, to join our team of caring professionals.

Purpose of position: Direct and manage the day-to-day operations of the Utilization Review department. 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 Utilization Management 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.

At North Tampa Behavioral Health, we offer competitive compensation, benefits and regular opportunities for development and advancement.

Job Requirements:

Education: Bachelor's Degree in nursing or other clinical field required. Master's Degree in clinical field preferred.

Experience: Four (4) or more years’ experience in Utilization Management required. Three (3) or more years of supervisory experience required. Six (6) or more years’ of clinical experience in behavioral health field preferred.

Licensures/Certification: Florida Registered Nurse (RN) licensure preferred. Crisis Prevention Intervention (CPI) certification (will provide training for CPI), required.

Education

• Masters or better in Social Work or related field

Equal Opportunity Employer/Protected Veterans/Individuals with Disabilities

The contractor will not discharge or in any other manner discriminate against employees or applicants because they have inquired about, discussed, or disclosed their own pay or the pay of another employee or applicant. However, employees who have access to the compensation information of other employees or applicants as a part of their essential job functions cannot disclose the pay of other employees or applicants to individuals who do not otherwise have access to compensation information, unless the disclosure is (a) in response to a formal complaint or charge, (b) in furtherance of an investigation, proceeding, hearing, or action, including an investigation conducted by the employer, or (c) consistent with the contractor’s legal duty to furnish information. 41 CFR 60-1.35(c)