Director of Utilization Management
River Edge Macon, GA
- Expired: over a month ago. Applications are no longer accepted.
About River Edge Behavioral Health
Serving more than 10,000 Georgians, River Edge continues to be one of the state's leading resources for mental health, substance use disorder treatments and supports as well as individuals with intellectual and development disabilities.
The full continuum of River Edge Behavioral Health services provide state-of-the-art treatment and support services for more than 13,000 children, youth, families and adults annually, who experience mental illness, addiction, co-occurring disorders or developmental disabilities.
- A minimum of seven years' experience in a clinical supervisory role at a Community Service Board
- Experience running a large CSB site and supervising more than 10 employees
- Minimum three years working in a Utilization Management role in a large CSB overseeing Authorizations, training clinical staff on quality of documentation and service delivery and leading a Medicaid and/or ASO Quality Review
- Experience with CARF Accreditation requirements
- Efficient with multiple Electronic Health Record systems, especially CareLogic
General Job Duties/Role of UMC:
- Documentation training for clinical and clerical staff
- Assist UM Director with development of training material
- Travel required to different locations
- CARF and Audit Preparation
- Review of service documents and process for compliance
- Programmatic and Record preparation required for Survey, Review and Audit
- Service Guideline quarterly review and update
- Review changes
- Monthly reports on key Programs and service areas
All selected applicants must pass a satisfactory background/motor vehicle clearance and pre-employment drug test.
Due to the volume of applications received, we are unable to provide information on application status by phone or e-mail. All qualified applicants will be considered; however, only those selected for an interview will be contacted by the hiring managers. Applicants who are not selected will receive notification via email. This position is subject to close at any time once a satisfactory applicant pool has been identified.
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