Utilization Review Specialist - PRN
Utilization Review Specialist - PRN
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Not Disclosed
Salary Not Disclosed
1 Vacancy
Job Description
ESSENTIAL FUNCTIONS:
- Provide consultation and guidance regarding admissions and patient length of stay to a variety of payers.
- Secure authorizations with insurance companies for inpatient treatment and continue to obtain authorizations for duration of patient stay.
- Evaluate the utilization program for compliance with regulations policies and procedures.
- Review clinical documentation from denied stays against criteria to determine if documentation is adequate for requested treatment.
- Provide staff management to including hiring development training performance management and communication to ensure effective and efficient department operation.
- This is an onsite position. Non Remote
- EDUCATION/EXPERIENCE/SKILL REQUIREMENTS:
- Associates degree required. Bachelors or masters degree in social work behavioral or mental health Nursing or other related health field preferred.
- Four or more years clinical experience with the population of the facility and previous experience in utilization management required.
Required Experience:
Unclear Seniority
Employment Type
Full-Time
