Director-Utilization Management

We offer a full suite of benefits ranging from:

• Competitive Pay Rate
• Paid Time Off
• Paid Holidays
• Medical, Dental, & Vision Insurance
• FSA & HSA Plans
• Long-Term & Short-Term Disability
• Company Paid Life Insurance
• Supplemental Life Insurance
• Employee Assistance Program
• Employee Discount Program
• 401(k) Retirement Plan with Company Match

Salary Range: $101,500 to $125,000 DOE

THIS POSITION REQUIRED DAILY ATTENDANCE ON SITE - NO REMOTE WORK AVAILABLE

Coachella Valley Behavioral Health, a new premier inpatient treatment center for adults age 18 and older, is opening soon and will set the standard for nursing care in behavioral health. Our 80-bed hospital offers comprehensive training, dynamic leadership, and personalized support so you can achieve your greatest potential.

Director - Utilization Management responsibilities include:

• ​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.

​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.