Director of Utilization Management

Director of Utilization Management

Headquarters - Gainesville, FL 32606

Salary Range $68,390.00 - $71,809.00 Salary Position Type Full Time Education Level 4 Year Degree

The Director of Utilization Management is responsible for overseeing service authorizations and the Certified Behavioral Health Assessment (CBHA) process, ensuring that services for children are producing desired outcomes and are achieving permanency and for managing a team of individuals who serve to make direct connections between the needs of the community's children and families and the providers that meet those needs.

This position is also responsible for the continuous quality improvement and data analytics associated with the Utilization Management (UM) units and may serve in other such capacities outside of these units. This position reports directly to the Vice President of Information Technology and Utilization Management.

ESSENTIAL JOB FUNCTIONS

• Provides direct supervision of professional and administrative positions assigned to the Utilization Management Department.
• Analyzes and reports Utilization Management data for use in budget analyses, staffing and service allocation considerations, quality improvement, and performance measure analyses.
• Tracks, manages, and reports on department spending, based on the annually approved departmental budget, which includes collaborating with the Finance Department to review spending and allocations.
• Assists with developing specifications and system operation, efficiencies, and maintenance for data capturing systems used within the Utilization Management Department.
• Leads the Quality Improvement process within UM, providing input and observations to management staff and the Quality Operations units regarding behavioral health provider performance.
• Reviews utilization of behavioral health and supportive services provided in in-home and outpatient settings to ensure the maximization of resources.
• Provides oversight and support for staff processing and reviewing CBHA materials.
• Reviews and approves invoices for payment ensuring appropriate use of state, federal, and other funding sources, appropriate coding, and cost allocations are utilized to facilitate maximization of resources.
• Interacts with community agencies to assist children with returning home or achieving permanency.
• Oversees and directs training relevant to UM including provider and service array with case management, Department of Child & Families (DCF), and other stakeholders.
• Knows and understands the processes to be followed in relation to complaints by employees regarding harassment and/or retaliation. Fairly and consistently applies all human resource policies as it relates to subordinate staff.
• Provides documentation to the Vice President of IT in matters of hiring and discipline but lacks the ability to unilaterally hire and terminate.
• Displays understanding of, and sensitivity to, service population's cultural and socioeconomic characteristics.
• Performs other related job duties as assigned.

Education and Experience:

Bachelor's degree in related human services or human behavioral field or equivalent;
Master's degree in the like preferred; and four (4) years of relevant experience in child welfare, behavioral health, or related field, to include two (2) years in a supervisory capacity; some experience in a Utilization Management function; or an equivalent combination of education and experience.

Special

Qualifications:

Certified as a Child Protection Professional preferred.

Licensed Mental Health Professional preferred.

Possession of a valid, State of Florida driver's license to operate the motor vehicle operated. Requirement exists at the time of hire and as a condition of continued employment.