Director of Utilization and Case Management

Behavioral Hospital Of Bellaire - Houston, TX

Full-time - Senior

Houston, TX

10,001+ employees

Hospitals

About the position

The Director of Utilization and Case Management at Behavioral Hospital of Bellaire is responsible for overseeing the Utilization Management programs for both inpatient and outpatient services. This role involves implementing case management scenarios, consulting with various disciplines to ensure effective treatment plans, and interfacing with managed care organizations and external reviewers. The position is crucial for maintaining the quality of care and ensuring compliance with treatment protocols.

Responsibilities

• Direct and oversee the Utilization Management programs for inpatient and outpatient services.
• Implement case management scenarios to ensure effective treatment plans for all patients.
• Consult with all disciplines involved in patient care to coordinate treatment efforts.
• Oversee responses to requests for services and ensure compliance with treatment protocols.
• Interface with managed care organizations, external reviewers, and other payors.

Requirements

• Degree in nursing, social work, mental health/behavioral sciences, or related field required; Master's Degree preferred.
• Minimum of five (5) years direct clinical experience in a psychiatric or mental health treatment setting.
• At least one (1) year in a management or supervisory capacity.
• Experience in patient assessment, family motivation, treatment planning, and communication with external review organizations.
• Licensure as L.V.N., R.N., L.P.C., L.M.S.W. or applicable license.

Benefits

• Health insurance
• Dental insurance
• Paid time off
• Vision insurance
• 401(k) matching