Utilization Review Specialist

Nendaz , Wallis, Switzerland

Type: n/a

Category: IT & Internet & Media

Requirements: English
Company: Acadia Healthcare
Region: Nendaz , Wallis

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:

1. Providing consultation and guidance regarding admissions and patient length of stay to a variety of payers.
2. Securing authorizations with insurance companies for inpatient treatment and continue to obtain authorizations through ongoing clinical reviews until patient discharges from treatment.
3. Evaluating the utilization operation for compliance with mandatory policies and procedures.
4. Reviewing clinical documentation from denied stays against criteria to determine if documentation is adequate for requested treatment.
5. Maintaining efficient, positive customer service attitude towards patients, their families and co-workers while being responsive to customer needs.

EDUCATION/EXPERIENCE/SKILL REQUIREMENTS:

Associate''s degree in nursing (LPN or RN) required. Bachelor''s 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 experience in 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.

Qualifications

Skills

Behaviors

Preferred

Detail Oriented

: Capable of carrying out a given task with all details necessary to get the task done well

Team Player

: Works well as a member of a group

Dedicated

: Devoted to a task or purpose with loyalty or integrity

Motivations

Preferred

Growth Opportunities

: Inspired to perform well by the chance to take on more responsibility

Job Security

: Inspired to perform well by the knowledge that your job is safe

Self-Starter

: Inspired to perform without outside help

Goal Completion

: Inspired to perform well by the completion of tasks

Ability to Make an Impact

: Inspired to perform well by the ability to contribute to the success of a project or the organization

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