Utilization Review Manager
Utilization Review Manager
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Salary Not Disclosed
1 Vacancy
Job Description
The Utilization Review Case Manager requires effective communication and coordination with the Director of Utilization Review insurance companies admissions coordinators and treatment team to obtain the maximum benefits for our clients. You will have oversight of Discovery Behavioral Health Programs. You will make sure you can submit accurate utilization reviews in an extremely tight timeline. Good verbal and written communication skills is required. Record keeping must be accurate and thorough. You must be able to discern medical necessity to for a busy and growing drug alcohol and mental health facility. Flexibility with your schedule so that you can meet critical deadlines as established is essential.
Responsibilities
- Conduct pre-authorizations for admitting clients that require it based on payer geography or low acuity.
- Provide clinical guidance and support to the Admissions Coordinators as it relates to medical necessity criteria and appropriate level of care.
- Conduct weekly UR office hours/consultation groups.
- Track and closely monitor authorization status and length of stay and provide coaching/support and direction in order to increase funded length of stay
- Create implement and enforce UR policies and procedures.
- Create and maintain UR manual including payer specific criteria guidelines and disseminate to all clinical staff.
This is a full-time position.
Qualifications :
- Required Bachelors Degree Masters Degree preferred
- Licensed LMFT LCSW LPCC or RN
- Prior experience in doing utilization review for mental health facilities
- Strong knowledge of medical necessity criteria
- Knowledge of DSM-V Codes
- Previous employment working with Mental Health Disorders preferred.
- Knowledge of RTC PHP and IOP Mental Health programs
Not sure if you meet all the qualifications Apply anyway! To provide truly innovative care we need to have a diverse team around us. Thats why Discovery Behavioral Health is committed to creating an inclusive environment. If you find yourself meeting some but not all the above wed be happy to consider your application.
Additional Information :
We are proud to be an EEO employer M/F/D/V. We maintain a drug-free workplace and perform pre-employment substance abuse testing. All qualified applicants will receive consideration for employment without regard to age race color religion sex or national origin.
For more information about our company benefits please visit us at Behavioral Health seeks to build a diverse staff that is reflective of the patients we serve and the communities where we work. DBH encourages multiple perspectives experiences and strives to hire and retain a diverse workforce.
Remote Work :
No
Employment Type :
Full-time
Employment Type
Full-time
