Director of Utilization Management

Summary

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Under the direction of the Chief Compliance Officer, responsible for oversight, discharge planning, and effective utilization of a variety of purchased services provided to high risk, high need CODAC members in hospitals, residential and transitional services, Intensive Recovery Team (IRT), wrap around services provided to Level I discharges, ASH, detoxification services and transitional services;

communicates with CODAC staff, internal and external stakeholders to ensure effective utilization of these services. Provides supervision and oversees functions of the Supervisor’s.

Areas of Responsibility

• Intensive Recovery Team
• Gila House
• Adult Transitional Living
• Clinical / Licensure Supervision

Essential Duties and Responsibilities

• Directs and monitors all aspects of agency managed care and other clinical services as assigned.
• Coordinates systems around 24-hour admissions and discharges, site-based and mobile services.
• Provides support to staff and participates in daily activities essential to the completion of program objectives, including, but not limited to, assessment, evaluation, and treatment of clients.
• Promotes member care consistent with the philosophy and objectives of CODAC and in compliance with County, State, Federal Regulations and Accrediting Standards;

monitors staff compliance and implementation with agency policies and procedures.

• Directs assigned program activity and is responsible for ensuring contract compliance within assigned program areas, consistent with agency and funding source requirements.
• Participates in preparation and implementation of the agency budget.
• Coordinates the development and implementation of new clinical programs and services based on community need and consistent with the organization's mission as assigned.
• Attends requested agency and community meetings and communicates pertinent information to appropriate staff.
• Specific involvement with QMC, OE, Clinical QM, Safety Committee, Mortality / Sentinel Events and SMT Committees.
• Prepares and submits timely and accurate reports and other documents related to program services and activities.
• Makes community presentations and, as assigned, represents the agency at meetings and professional or community functions.
• Reviews and prepares reports for the purpose of monitoring assigned program activities and functions.
• Coordinates services with other behavioral health agencies, service organizations, and other community resources.
• Ensures programs are aligned with CODAC’s mission statement.
• Coordinates and / or assigns activities with statewide community-based agencies, housing funders, the RBHA, and community partners.
• Develops and monitors budgets for CODAC programs.
• Provides direct therapeutic services as necessary.
• Responsible for coordinating and writing initial grant and contract proposals.
• Participates and collaborates with the Tucson Pima Collaboration to End Homelessness.
• Performs other related activities in accordance with agency growth and changes.

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