Director of Utilization

Overview

Bowling Green Inn at Brandywine is seeking a Director of Utilization to join our team! 

100% On-site role in Kennett Square, PA

Located in the scenic and historic countryside of Pennsylvania’s Brandywine River Valley, Bowling Green Inn at Brandywine has been a premier provider of effective chemical dependency treatment for more than 30 years. Bowling Green Brandywine is a 200-bed Alcohol and Drug Rehab Treatment Center in Kennett Square, PA.

Bowling Green Inn at Brandywine offers an extensive array of benefits to our valued team members. Current offerings encompass: 

• Medical, Dental, and Vision Insurance coverage
• Health Savings Account (HSA) and Flexible Spending Account (FSA) options
• Company-paid Basic Life & AD&D insurance
• Disability benefits
• 401(k) Retirement Plan with a company match
• Employee Assistance Program (EAP) and Employee Discount Program
• Paid Holidays for work-life balance
• Paid Time Off (PTO) 
• Tuition Reimbursement opportunities for career advancement 

​PURPOSE STATEMENT: 

​Direct and manage the day-to-day operations of the Utilization Review department. 

Schedule: on site; Monday - Friday with weekend availability

Responsibilities

​ESSENTIAL FUNCTIONS: 

• ​Monitor utilization of services and optimize reimbursement for the facility while maximizing use of the patient’s provider benefits for their needs.   
• ​Conducts and oversees concurrent and retrospective reviews for all patients.   
• ​Act as a liaison between Medicaid reviewers and the staff completing required paperwork to facilitate the Utilization Review process.   
• ​Collaborates with physicians, therapist and nursing staff to provide optimal review based on patient needs.   
• ​Collaborates with ancillary services in order to prevent delays in services.   

• ​Evaluates the UM program for compliance with regulations, policies and procedures. 
• ​May review charts and make necessary recommendations to the physicians, regarding utilization review and specific managed care issues.   
• ​Provide staff management to including hiring, development, training, performance management and communication to ensure effective and efficient department operation. 

​OTHER FUNCTIONS:  

• ​Perform other functions and tasks as assigned. 

Qualifications

EDUCATION/EXPERIENCE/SKILL REQUIREMENTS: 

• ​Bachelor's Degree in nursing or other clinical field required. Master's Degree in clinical field preferred.  
• ​Six or more year's clinical experience with the population of the facility preferred. 
• ​Four or more years’ experience in utilization management required.    
• ​Three or more years of supervisory experience required. 

​LICENSES/DESIGNATIONS/CERTIFICATIONS:  

• ​If applicable, current licensure as an LPN or RN within the state where the facility provides services; or current clinical professional license or certification, as required, within the state where the facility provides services. 

We are committed to providing equal  employment opportunities to all applicants for employment regardless of an individual’s characteristics protected by applicable state, federal and local laws.

AHCORP

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