Foundry Treatment Center Steamboat

• Manage and supervise the Utilization Review team, including hiring, training, scheduling, and performance management. • Oversee authorization and reauthorization processes for behavioral health services across payors. • Ensure compliance with federal, state, and payor-specific regulations and guidelines. • Review clinical documentation to confirm medical necessity and completeness. • Serve as the primary escalation point for complex cases, denials, and peer-to-peer reviews. • Track and analyze utilization metrics, authorization turnaround times, and denial trends. • Collaborate with clinical leadership to improve documentation practices and treatment planning. • Develop and maintain utilization review policies, procedures, and workflows. • Support audits, accreditation reviews, and quality improvement initiatives. • Communicate effectively with insurance companies, clinicians, and internal stakeholders. • Other duties as assigned.

• Facilitate one-on-one and group therapy sessions. • Complete service plans and updates for caseload. • Monitor/observe Mouth Swab tests as needed and document appropriately. • Provide support services to individuals in treatment. • Collaborate with clinical, medical, and admissions staff. • Contribute to clinical decisions, recognize and demonstrate treatment is a team effort. • Create and maintain a safe, comfortable, and person-focused treatment environment. • Ensure client safety and satisfaction. • Comprehend, follow, and enforce policies & procedures with clients. • Attend all required team meetings. • Communicate medical concerns to Medical Team. • Identify emergency signals and situations and respond appropriately. • Constant awareness and communication with clinical team, family members, and client. • Complete documentation within time frames set by the organization’s policy as required by license and accreditation standards. • Maintain strict confidentiality, HIPAA and 42CFR Part 2 compliance. • Adhere to organization’s policies & procedures, State & Federal law, OSHA, JCAHO, and BHA regulations & standards. • Represent the organization's mission and values.