Director of Utilization Review

Director of Utilization

To manage and coordinate the Utilization Review process , to assess the medical appropriateness of the care needed and the organization's course of treatment through gathering and communicating information from and to the clinical treatment team and other necessary individuals. To provide the patient, family and payor assurance of the appropriateness, value and quality of healthcare services being offered. To use current admission criteria and standard review protocols for positively impacting the medical care being delivered and ensuring the most appropriate use of the patient's benefits.

Minimum Education

Bachelor's Degree in Nursing preferred, or an equivalent combination of education and experience.

Minimum Work Experience

RN, MSW, LCSW, MFT, LVN or LPT with at least (3) years of direct clinical experience in psychiatric or behavioral health treatment setting. Outpatient clinical...