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Director-Utilization Management

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Acadia Healthcare Inc.

2024-09-21 02:39:18

Job location Norcross, Georgia, United States

Job type: fulltime

Job industry: Other

Job description

Conduct admission and concurrent reviews for assigned program patients; obtain admission information and insurance verification/benefits information from the Admissions Department. Reviews charts and conducts pre-certification reviews with third party payors as required within specified time limits. Communicates results of reviews to physicians and treatment team members. Serves as liaison to on-site external reviews. Maintains relevant reports and data for UR Department. Completes all paperwork related to pre-certification and concurrent reviews according to UR policies. Daily communication with physicians, treatment team and Business Office regarding certification and denials. Coordinate and participate in the treatment planning process. Monitor documentation, discharge planning process providing feedback on documentation processes. Conducts ongoing reviews of clinical charts. Facilitates Peer Review as outlined in Utilization Management Plan. Administrative policies and procedures and a high level of confidentiality.

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