UR Specialist
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Job Location:
Brooksville, PA - USA
Monthly Salary:
Not Disclosed
Posted on:
30+ days ago
Vacancies:
1 Vacancy
Job Summary
Are you prepared for the impact you can make in your UR career at a well-respected treatment center in Brooksville Florida If so you may enjoy working at Sabal Palms Recovery Center an addiction treatment facility nestled on a 10-acre campus located along Floridas Nature Coast and surrounded by live oak trees. Sabal Palms Recovery Center provides premier residential treatment for adults aged 18 and older who are struggling with addictions.
Our skilled professionals are focused on sharing their knowledge and expertise to help you get acclimated to your new role. Along with detailed training and continual support our staff will give you the autonomy you need to achieve your career goals. You will love working to make a difference in the lives of our patients as you collaborate with other professionals and a supportive management team.
We are looking to for a Full Time Utilization Review Specialist to join our team. The UR specialist proactively monitors utilization of services for patients to optimize reimbursement for the facility. This is a Monday-Friday day position working 40 hours per week.
ESSENTIAL FUNCTIONS:
- Act as liaison between managed care organizations and the facility professional clinical staff.
- Conduct reviews in accordance with certification requirements of insurance plans or other managed care organizations (MCOs) and coordinate the flow of communication concerning reimbursement requirements.
- Monitor patient length of stay and extensions and inform clinical and medical staff on issues that may impact length of stay.
- Gather and develop statistical and narrative information to report on utilization non-certified days (including identified causes and appeal information) discharges and quality of services as required by the facility leadership or corporate office.
- Conduct quality reviews for medical necessity and services provided.
- Facilitate peer review calls between facility and external organizations.
- Initiate and complete the formal appeal process for denied admissions or continued stay.
- Assist the admissions department with pre-certifications of care.
- Provide ongoing support and training for staff on documentation or charting requirements continued stay criteria and medical necessity updates.
EDUCATION/EXPERIENCE/SKILL REQUIREMENTS:
- High School diploma or equivalent required.
- Two or more years experience with the population of the facility and previous experiencein utilization management preferred.
LICENSES/DESIGNATIONS/CERTIFICATIONS:
- CPR and de-escalation/restraint certification required (training available upon hire and offered by facility).
- First aid may be required based on state or facility.
BENEFITS:
- Medical Dental and Vision Insurance
- HSA & FSA
- Company Paid Basic Life & AD&D
- Disability
- 401(k) Retirement Plan - with company match
- Employee Assistance Program/Employee Discount Program
- Paid Holidays
- Paid Time Off
- Tuition Reimbursement
Required Experience:
IC
Key Skills
- Sales Experience
- Crane
- Customer Service
- Communication skills
- Heavy Equipment Operation
- Microsoft Word
- Case Management
- OSHA
- Team Management
- Catheterization
- Microsoft Outlook Calendar
- EHS
About Company
Acadia Healthcare operates a network of premier behavioral healthcare facilities in the United States and Puerto Rico. Offering multiple levels of care for all populations.
