Utilization Management Director jobs in Tennessee

BENEFITS:

• Competitive salary
• Medical, dental, and vision insurance
• Employee Discount Program
• Employee Assistance Program
• Acadia Healthcare 401(k) plan
• Excellent training program
• Professional growth opportunity that is second to none in the industry! Join a team with defined career paths and a national family of hospitals and facilities

ESSENTIAL FUNCTIONS:

• Act as liaison between managed care organizations and the facility professional clinical staff.
• Conduct reviews, in accordance with certification requirements, of insurance plans or other managed care organizations (MCOs) and coordinate the flow of communication concerning reimbursement requirements.
• Monitor patient length of stay and extensions and inform clinical and medical staff on issues that may impact length of stay.
• Gather and develop statistical and narrative information to report on utilization, non-certified days (including identified causes and appeal information), discharges and quality of services, as required by the facility leadership or corporate office.
• Conduct quality reviews for medical necessity and services provided.

EDUCATION/EXPERIENCE/SKILL REQUIREMENTS:

• Associate's degree in nursing (LPN or RN) required. Bachelor's or Master’s degree in social work, behavioral or mental health, nursing or other related health field preferred.
• Two or more years' experience with the population of the facility and previous experience in utilization management preferred.