If you are searching for a fulfilling place to develop your career and an opportunity to make a difference in helping others, then keep reading on. Here at AAC, we have a progressive culture; we listen to your ideas, value a work/life balance, invest in education, and we foster trust and respect for all individuals. Our exceptional comp and strong benefits include employee stock purchase program, medical, dental, vision and life insurance. We are looking for our future leaders, who are not only going to fill the qualifications for this job description, but who are going to exceed expectations. Be a part of a team whose mission is to provide quality, compassionate, and innovative care to adults struggling with addiction and co-occurring mental health disorders. Our purpose and passion are to empower patients, their families, and our communities by helping individuals achieve recovery and optimal wellness of the mind, body, and spirit.
Reports to: Facility CEO
FLSA Status: Exempt
The Director of Utilization Review Management is responsible for the direct supervision, education, mentoring and enhancement of UR Team performance and day-to-day operations of the Utilization Management Departments. The Director will contribute to AAC’s success by ensuring appropriate competency of staff, appropriate authorizations and length of stay management based medical necessity criteria, evidence-based medicine and collaboration with internal teams and will ensure effective management of medical necessity denials
Serve as the Director for designated AAC location.
Work closely with Administration team leaders and Vice President of Utilization Management
Develops programs to promote integration of addiction, behavioral health and medical services which support continuity and coordination among payors
Overall responsibility for implementation of the Utilization Management programs
Monitors substance abuse utilization authorization and claims data
Assures that policies adhere to contractual obligations
Develop targeted education and training for and provide clinical guidance to the UR Coordinators
Provides direct supervision and mentorship to UR team
Completes quality audits on staff and monitors and improves productivity
Consultation with practitioners and clinical SME’s to create process improvements
Participation in clinical workgroups as required
Participation in committees as required
Negotiates Single Case Agreements with out of network providers when indicated.
Develops new policies and procedures when indicated.
Builds on the organizations mission.
Education, Experience, Skills & Ablilities:
To perform this job successfully, an individual must be able to perform each essential duty satisfactorily. The requirements listed below are representative of the knowledge, skill, and/or ability required. Reasonable accommodations may be made to enable individuals with disabilities to perform the essential functions.
AAC is committed to principles of equal opportunities for all employees. The Company will provide reasonable accommodations that are necessary to comply with State and Federal disability discrimination laws.