Director of Utilization Review

Job Description

Job Description

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 experience highly desirable. Utilization Management / UR or insurance case management experience and familiarity with insurance benefit language required.

Required License(s) :

RN, MSW, LCSW, MFT, LVN or LPT license required.

Job Type : Full-time

Salary : $63,000.00 - $80,000.00 per year

Benefits :

401(k)

Dental insurance

Employee assistance program

Flexible spending account

Health insurance

Life insurance

Paid time off

Vision insurance

Medical specialties :

• Psychiatry
Physical setting :
• Outpatient

Schedule :

• 8 hour shift
• Monday to Friday

Ability to commute / relocate :

• Ventura, CA 93003 : Reliably commute or planning to relocate before starting work (Required)

Experience :

• Utilization review : 2 years (Preferred)

License / Certification :

• RN (Preferred)

Benefits

At Vista del Mar Hospital, you will find yourself in a position with great growth potential. We make it a priority to provide advancement opportunities and ongoing education for our entire team, in both clinical and non-clinical roles. This helps us ensure ongoing patient safety and quality care across our facility.

Each of our professionals is compassionate and committed to the goal of excellence in the mental health care industry. Because we bring on the most reputable and experienced healthcare professionals to fill our open behavioral health jobs, our goal is to keep them long-term. This is better for patients and our own staff, as it allows everyone to feel more comfortable in their environment.

Although a mental health career with Vista del Mar can be extremely rewarding in its own right, we understand the importance of employee benefits. Vista del Mar offers the following :

• Health Insurance
• Vision Insurance
• Dental Insurance
• 401K Retirement Plan
• Healthcare Spending Account
• Dependent Care Spending Account
• PTO Plan with Holiday Premium Pay
• Discounted Cafeteria Meal Plan
• Life Insurance (Supplemental Life, Term and Universal plans are also available.)
• Short and Long-Term Disability (with additional buy-in opportunities)