Director of Utilization Review/Case Mgt

1 month ago


Monroe, United States Freedom Behavioral Hospital of Monroe Full time
Job DescriptionJob DescriptionSalary:


Freedom Behavioral Hospital of Monroe has an immediate opening for a Utilization Review representative.  At Freedom, we put patient care first in all we do, and our people make that possible. We know that your best work happens when you live your best life and share your unique talents.  If fulfilling your career potential in an environment where you know you have made a difference in the lives of others sounds appealing, this is the job for you.


The Utilization Review representative provides appropriate care and assesses and interprets data based on the patient's status and the age specific needs of the individual. Analyzes patient records to determine legitimacy of admission, treatment, and length of stay to comply with governmental and insurance company requirements.  This position is responsible for review of precertification requests for medical necessity, referring to the medical director those that require additional expertise.  The Utilization Review representative will review clinical information for concurrent reviews, extending the length of stay for patients as appropriate and provide appropriate consultation and referral to Case Management/Social Services personnel. 


PREFERRED KNOWLEDGE, SKILLS, AND/OR EXPERIENCE REQUIRED:
Education: A psychology major is preferred or nursing education
License: Nursing License, Social Worker License 
Experience: 1+ years coordinating utilization review - verifying benefits and pre-certifications with insurance agencies and discharge planning activities
General  Requirements:
Effective verbal communication skills
Effective organizational skills
Effective interpersonal skills
Analytical problem solving skills
Ability to read and comprehend written instructions; ability to follow verbal instructions
Proficient knowledge of PC computers
Basic understanding of DSM V diagnostic criteria
Basic understanding of medical and psychiatric diagnoses and conditions


****All Applicants selected for employment will be required to undergo a post-offer drug test and federal background investigation.  




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