Utilization Review Specialist - Lafayette, United States - Denver Springs

Description

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OverviewSycamore Springs Fully In-Person Role Utilization Review SpecialistFull Time, Monday-FridayMembers of our team Enjoy:
Working with a highly engaged staffHealthy staffing levelsFlexible schedulingCareer growthCompetitive compensationHealth, Vision, Dental, 401k, and Paid Time OffUKG Wallet

• We've partnered with UKG Wallet, a voluntary Earned WageAccess benefit, to offer employees access to their pay on their own schedule.

Sycamore Springs is a 44-bed behavioral hospital located in Lafayette, IN.The hospital offers inpatient and outpatient mental health and addictiontreatment to adults, adolescents and their families.

At Sycamore Springs,we are dedicated to Changing People's LivesThe Utilization Review department plays an essential role in helping fulfillour mission of 'Changing People's Lives'.

Utilization Review teammembers advocate on behalf of our patients to managed care providers fornecessary treatment. As a Utilization Review Specialist, you willaccurately and timely complete utilization review activities.
Position DetailsActs as a liaison between managed care organizations and the facility'sbehavioral health clinical treatment team.
Conducts clinical reviews in accordance with certification requirements ofinsurance plans or other managed care organizations.

Monitors patient length of stay and conducts initial and concurrent reviewswhen indicated to provide clinical information needed to support medicalnecessity criteria for appropriate level of care.

Facilitates peer to peer reviews between the facility treatment provider andthe managed care physician.
Assists the Assessment Department with completion of the precertificationprocess for admissions.
Provides ongoing support and training for staff on documentationrequirements, admission and continued stay criteria, and medical necessityupdates.


QualificationsQualifications:
Knowledge of mental health and chemical dependency terminology, symptoms,diagnoses, and treatment.
Ability to communicate effectively with patients, internal and externaltreatment providers, and managed care clinical review care managers.

Ability to multi-task, pay attention to detail, problem solve, utilizecritical thinking skills, prioritize, and work both independently and as apart of a team.

Strong computer skills and ability to navigate electronic systems applicableto job functions.


Requirements:

Bachelor's degree or current clinical license required in lieu of degreeCPR and CPI Certification within 30 days of employmentExperience:Previous utilization review experience in a psychiatric healthcare facilitypreferredEducation and experience in the field(s) of: Social Work,Psychology, Psychiatric Nursing, Marriage and Family and ChildCounseling, Chemical Dependency Counseling, Registered Nursing or aclosely related science fieldEqual Opportunity Employer Minorities/Women/Veterans/DisabledSpringstone, Inc.

is an Equal Opportunity Employer.

All qualified applicantswill receive consideration for employment without regard to race, color,religion, sex, sexual orientation, gender identity, national origin,or protected veteran status and will not be discriminated against on the basisof disability.

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