What are the responsibilities and job description for the Utilization Review Director position at CommuniCare Health Services?
A Behavioral Health hospital in the Columbus, OH area is recruiting a licensed clinician to lead our Utilization Review team.
The Utilization Review Director oversees the Utilization Review Department for both Inpatient and Outpatient Services. This includes the precertification and recertification process, peer to peer reviews, and appeal. The Utilization Review Director will ensure an appropriate discharge plan is in place for each patient discharge. The Director will accurately report the authorization status of patients and denials and appeals status to the CEO, CFO, and Business Office staff. The Director will ensure all Utilization Review staff follow department and facility procedures and ensure effective communication with all relevant departments regarding patient care needs.
Our company offers competitive wages, Paid Time Off packages, and a full, robust benefits package.
Qualifications
The Utilization Review Director oversees the Utilization Review Department for both Inpatient and Outpatient Services. This includes the precertification and recertification process, peer to peer reviews, and appeal. The Utilization Review Director will ensure an appropriate discharge plan is in place for each patient discharge. The Director will accurately report the authorization status of patients and denials and appeals status to the CEO, CFO, and Business Office staff. The Director will ensure all Utilization Review staff follow department and facility procedures and ensure effective communication with all relevant departments regarding patient care needs.
Our company offers competitive wages, Paid Time Off packages, and a full, robust benefits package.
Qualifications
- Education: Bachelor’s Degree in Nursing, Social Work, Mental Health/Behavioral Sciences, or related field required; Master’s Degree preferred.
- Work Experience: Direct clinical experience in a psychiatric or mental health treatment setting, including managing a related function preferred. Experience in patient assessment, family motivation, treatment planning, and communication with external review organizations or comparable entities.
