What are the responsibilities and job description for the Director of Utilization position at Geisinger Behavioral Health Center Danville?
Overview
Acadia Healthcare and Geisinger Health have partnered to establish a state-of-the-art, 96-bed behavioral health hospital in Danville, PA. Geisinger Behavioral Health Center Danville will serve pediatric and adult patients, offering inpatient treatment, intensive outpatient programming, and ECT services. It will also serve as a teaching hospital for students and residents of Geisinger’s College of Health Sciences. Set to open in Summer 2025, this facility will help meet the urgent need for accessible, high-quality psychiatric care in the region, expanding capacity to support patients with diverse mental health needs.
What would you do in this role?
The Director of Utilization will direct and manage the day-to-day operations of the Utilization Review department.
Responsibilities
ESSENTIAL FUNCTIONS:
- 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.
OTHER FUNCTIONS:
- Perform other functions and tasks as assigned.
Qualifications
EDUCATION/EXPERIENCE/SKILL REQUIREMENTS:
- Bachelor's Degree in nursing or other clinical field required. Master's Degree in clinical field preferred.
- Six or more year's clinical experience with the population of the facility preferred.
- Four or more years’ experience in utilization management required.
- Three or more years of supervisory experience required.
LICENSES/DESIGNATIONS/CERTIFICATIONS:
- If applicable, current licensure as an LPN or RN within the state where the facility provides services; or current clinical professional license or certification, as required, within the state where the facility provides services.
We are committed to providing equal employment opportunities to all applicants for employment regardless of an individual’s characteristics protected by applicable state, federal and local laws.
