Director of Utilization Management

Summary

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.
• Coordinate 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.
• Promotion of 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.