Director of Utilization at Coastal Pines Behavioral Health

St. Augustine, Florida, United States -

Full Time

Start Date

Immediate

Expiry Date

08 Aug, 26

Salary

0.0

Posted On

10 May, 26

Experience

10 year(s) or above

Remote Job

Yes

Telecommute

Yes

Sponsor Visa

Skills

Utilization Review, Utilization Management, Staff Management, Concurrent Review, Retrospective Review, Regulatory Compliance, Reimbursement Optimization, Clinical Supervision, Managed Care, Patient Care Coordination

Industry

Description

Overview Director of Utilization Management – New Behavioral Health Hospital near Jacksonville, FL - Opening Late Summer 2026 We are seeking an experienced Director of Utilization Management to direct and manage the day-to-day operations of the Utilization Review department. Coastal Pines will be a modern, purpose-built facility and a cornerstone of behavioral health care in Northeast Florida, designed to meet the growing demand for high-quality psychiatric services in the region. The 144-bed behavioral health hospital, located in St. Johns, will offer a full continuum of services including inpatient psychiatric care, Partial Hospitalization Program (PHP), Intensive Outpatient Program (IOP), and Electroconvulsive Therapy (ECT). What We Offer: Our leaders are equipped with the tools, support, and benefits they need to thrive: Competitive compensation package including performance-based incentives Comprehensive medical, dental, and vision insurance 401(k) plan with company match through Acadia Healthcare Equity/stock-based incentive awards for long-term financial growth Generous paid time off including vacation, holidays, and sick days If you're ready to lead with purpose and drive lasting impact in the behavioral health space, we invite you to consider joining us at Coastal Pines Behavioral Health. 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. AHGROW #LI-CPBH

Responsibilities

Direct and manage the day-to-day operations of the Utilization Review department to optimize reimbursement and maximize patient benefits. Collaborate with clinical staff and Medicaid reviewers to ensure compliance and efficient service delivery.