Director of Admissions & Utilization Review
Recovery Centers of America - St. Charles
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Post Date: Jun 11, 2020
Job Type: Full Time
Start Date: July 15, 2020
Salary: - n/a -
Location: US - Illinois - St. Charles
Job Reference: - n/a -
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Position Overview: Directs the admissions and utilization review management (UR) operations and staff for RCA. Serves as a point of contact for escalated utilization management decisions and works closely with Medical, Clinical and Primary Therapist teams. Ensures the admitting staff obtains necessary personal and financial data in determination patient’s eligibility for admission to an RCA facility. Develop processes and policies for admissions and utilization management that optimize patient outcomes and cost efficiency of services. Monitor utilization management decisions for quality, accuracy, and adherence to established criteria. Confirms that insurance benefit coverage meets standards of admissions.
Specific Responsibilities:
• Provides leadership and guidance to the Admissions and Utilization Review teams and their related caseloads and schedules.
• Provides reliable trending analysis of current and past data related to length of stay and days authorized by specific insurance companies.
• Collaborates closely with Medical team, Clinical team, and Primary Therapists to develop, implement, and evaluate the screening assessment, and admissions process, as well as the overall quality of the clinical program.

Masters level Clinician plus 3 years’ experience preferred or;
• LPN/RN plus 3 years’ experience.
• Ability to work as a member of a management team.
• Knowledge of State and Federal Statutes regarding patient confidentiality laws.
• Knowledge of State guidelines and accreditation agency standards.
• Knowledge and experience of all continuums of care, including admission assessment and continued stay criteria

Contact Details
Name: Anne Mullen
Address: 41W400 Silver Glen Road
City: St. Charles
State/Province: Illinois
Zipcode: 60175
Country: United States