Utilization Review Specialist
Company Name:
Brattleboro Retreat
Utilization Review Specialist
Department: Utilization Management
Schedule: Per Diem
Shift: Day Shift
Hours: Per Diem
Job Details:
JOB
Summary: Conduct pre-certification and utilization management functions for all behavioral health and substance abuse services offered by the Brattleboro Retreat. On-going contact with managed care companies and reviewers to provide initial clinical data for pre-certification. Update information to ensure authorization of all necessary days at most appropriate level of care. Conduct retrospective reviews as requested by manager of Utilization Review. Communication of information to clinical staff, physicians and fiscal services regarding days/services approved expectations of reviewers, review schedule, denial of stay, coordination of physician to physician reviews, and/or appeals.
NON-ESSENTIAL
Responsibilities:
May be required to perform duties of lesser, equal or greater responsibility.
Qualifications:
Working knowledge of level of care criteria.
Working knowledge of regulatory agencies preferred.
Excellent written and verbal communication skills, flexibility, strong team member and ability to establish positive working relationships with a variety of clinical staff.
Clinical knowledge.
Bachelor s Degree or equivalent experience in a related health care field.
Two years experience working in behavioral health field, hospital setting preferred.
Experience with computers and data entry; Microsoft Office.
Very strong in organization and time management.
PLEASE READ: Your computer may have specific settings that block popup boxes and forms. You must disable your popup blocker setting in order to access the online application form. (Go to Tools>Popup Blocker>Temporarily Allow Popups)Estimated Salary: $20 to $28 per hour based on qualifications.
Brattleboro Retreat
Utilization Review Specialist
Department: Utilization Management
Schedule: Per Diem
Shift: Day Shift
Hours: Per Diem
Job Details:
JOB
Summary: Conduct pre-certification and utilization management functions for all behavioral health and substance abuse services offered by the Brattleboro Retreat. On-going contact with managed care companies and reviewers to provide initial clinical data for pre-certification. Update information to ensure authorization of all necessary days at most appropriate level of care. Conduct retrospective reviews as requested by manager of Utilization Review. Communication of information to clinical staff, physicians and fiscal services regarding days/services approved expectations of reviewers, review schedule, denial of stay, coordination of physician to physician reviews, and/or appeals.
NON-ESSENTIAL
Responsibilities:
May be required to perform duties of lesser, equal or greater responsibility.
Qualifications:
Working knowledge of level of care criteria.
Working knowledge of regulatory agencies preferred.
Excellent written and verbal communication skills, flexibility, strong team member and ability to establish positive working relationships with a variety of clinical staff.
Clinical knowledge.
Bachelor s Degree or equivalent experience in a related health care field.
Two years experience working in behavioral health field, hospital setting preferred.
Experience with computers and data entry; Microsoft Office.
Very strong in organization and time management.
PLEASE READ: Your computer may have specific settings that block popup boxes and forms. You must disable your popup blocker setting in order to access the online application form. (Go to Tools>Popup Blocker>Temporarily Allow Popups)Estimated Salary: $20 to $28 per hour based on qualifications.
|
|
 | |
