Utilization Review Specialist
Utilization Review Specialist
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Salary Not Disclosed
1 Vacancy
Job Description
Come join our team as a Utilization Review Specialist at River Place Behavioral Health! If you are passionate and dedicated to making a difference in the lives of those in need through compassionate therapeutic practices while working in a team environment that supports learning and growth this position is right for you!
River Place Behavioral Health Hospital a service of Ochsner Health System is an 82 bed state of the art hospital located in Laplace Louisiana.
As a Utilization Review Specialist at River Place you will participate in the development and implementation of patients treatment plan by:
Providing consultation and guidance regarding admissions and patient length of stay to a variety of payers.
Securing authorizations with insurance companies for inpatient treatment and continue to obtain authorizations through ongoing clinical reviews until patient discharges from treatment.
Evaluating the utilization operation for compliance with mandatory policies and procedures.
Reviewing clinical documentation from denied stays against criteria to determine if documentation is adequate for requested treatment.
Maintaining efficient positive customer service attitude towards patients their families and coworkers while being responsive to customer needs.
EDUCATION/EXPERIENCE/SKILL REQUIREMENTS:
Associates degree in nursing (LPN or RN) required. Bachelors or Masters degree in social work behavioral or mental health nursing or other related health field preferred.
Two or more years experience with the population of the facility and previous experiencein utilization management preferred.
LICENSES/DESIGNATIONS/CERTIFICATIONS:
Current licensure as an LPN or RN with the state of LA; or current clinical professional license or certification as required.
Required Experience:
Unclear Seniority
Employment Type
Full-Time
