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Triangle Springs - Director of Utilization Review

Springstone


Location:
Raleigh, NC
Date:
06/22/2020
2020-06-222020-07-22
Job Code:
8a7883a861023dbc0161053a88ec1622
Categories:
  • Healthcare
Springstone
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Job Details

Title: Triangle Springs - Director of Utilization Review
JobID: 8a7883a861023dbc0161053a88ec1622
Location: Raleigh

Description:
Triangle Springs – Director of Utilization Review
 
Director of Utilization Review 
 
Triangle Springs is a 77-bed behavioral hospital located near Raleigh/Durham. The hospital offers inpatient and outpatient mental health and addiction treatment to adults, adolescents and their families. At Triangle Springs we are dedicated to Changing People’s Lives.
The Utilization Review department plays an essential role in helping fulfill our mission of “Changing People’s Lives®”.  Utilization Review team members advocate on behalf of our patients to managed care providers for necessary treatment.  As a Utilization Review Director, you will ensure your team accurately and timely completes utilization review activities.
Members of our team Enjoy:
  • Working with a highly engaged staff
  • Healthy staffing levels
  • Flexible scheduling
  • Career growth
  • Competitive compensation
  • A Comprehensive Benefit package is offered to Full and Part time team members
 
Position Details:
  • Oversee the Utilization Review department, ensuring staff has completed all assignments and monitors performance.
  • Ensure all pre-certifications are completed for inpatient and outpatient services.
  • Monitor hospital LOS, reports appropriately, and educates other departments regarding their role in maintaining appropriate length of stay for all patients. 
  • Assist with creation of treatment team agenda and participates to ensure team is aware of coverage info as well as collecting information for communication with insurance or other funding source
  • Interface with managed care organizations, external reviews, and other payers.
Requirements:
  • Bachelor’s Degree
  • Current unencumbered clinical licensure and valid drivers’ license
  • CPR and CPI Certification within 30 day of employment
Experience:
Previous utilization review experience in a psychiatric healthcare facility preferred

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