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Acadia Healthcare Director-Utilization Management in West Bloomfield, Michigan

Description

  • 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.

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