Director of Utilization Review Management Opportunity

Cumberland Hall Hospital is a 97 bed, licensed, acute psychiatric hospital located in beautiful Hopkinsville, KY. Cumberland Hall features individual units for youth, adults and active-duty military, and offers inpatient acute care, partial hospitalization, and intensive outpatient programs. On average, over 1500 patients receive care from our compassionate health care team each year at Cumberland Hall Hospital.

Website: https://cumberlandhallhospital.com/

Job Duties to include:

· Oversees all utilization management functions.

· Oversees precertification, concurrent, and discharge utilization reviews.

· Facilitates regulatory compliance by ensuring proper documentation and allocation of treatment resources.

· Serves as a key member of the hospital management team.

· Acts as a key participant in hospital operations meetings that drive financial and clinical results.

· Functions as a key liaison with all hospital physicians to align physician engagement with payer expectations, patient acuity and discharge planning requirements.

· Leads payer engagement activities including post payment reviews, payer audit oversight and denial/appeal oversight.

· Oversees the Utilization Management committee structure.

· Develops and monitors utilization management plans.

· Manages utilization management staff and performs all administrative department head functions.

This role will also be responsible for their own case-management load, while supporting and supervising the Utilization Review team.

As a senior leader, the Director of Utilization Management is a working director participating as an administrator on call and working evenings and weekends as required to support the team.

Director of Utilization Review Management Requirements:

• Education: Bachelor’s Degree from an accredited college or university in Nursing, Master’s Degree from an accredited college or university in nursing, social work, mental health, or related field preferred.
• Experience: A minimum of 3 years of experience working in an acute inpatient psychiatric setting as a treatment team member or 3-5 years of experience in utilization management for both mental health and substance abuse behavioral health disorders.

Pay: $69,321.60 - $103,982.40 per year

Benefits:

• 401(k)
• 401(k) matching
• Dental insurance
• Employee assistance program
• Employee discount
• Flexible spending account
• Health insurance
• Health savings account
• Life insurance
• Paid time off
• Referral program
• Retirement plan
• Tuition reimbursement
• Vision insurance

Work Location: In person