Current jobs related to Utilization Specialist - Nashville - Ascension St. Thomas Behavioral Health Hospital
-
Utilization Specialist
1 month ago
Nashville, Tennessee, United States Ascension St. Thomas Behavioral Health Hospital Full timeJob SummaryWe are seeking a highly skilled Utilization Specialist to join our team at Ascension St. Thomas Behavioral Health Hospital. As a Utilization Specialist, you will play a critical role in optimizing reimbursement for our facility by proactively monitoring patient utilization of services.Key ResponsibilitiesAct as liaison between managed care...
-
Senior Utility Support Specialist
2 weeks ago
Nashville, Tennessee, United States i3 Verticals Management Services, Inc. Full timeJob SummaryWe are seeking a highly skilled Senior Utility Support Specialist to join our team at i3 Verticals Management Services, Inc. The ideal candidate will have a strong background in utility industry and experience working with Customer Information Systems / Billing and Meter Data Management systems.The successful candidate will be responsible for...
-
Senior Utility Support Specialist
1 week ago
Nashville, Tennessee, United States i3 Verticals Full timeJob Title: Senior Utility Support SpecialistAt i3 Verticals, we are seeking a highly skilled Senior Utility Support Specialist to join our team. As a key member of our support operations, you will be responsible for providing top-notch support to our utility clients. Your expertise in utility industry and experience with Customer Information Systems /...
-
Clinical Utilization Specialist
1 month ago
Nashville, Tennessee, United States Newport Healthcare Full timeAbout UsNewport Healthcare is a leading provider of behavioral healthcare services, dedicated to delivering high-quality care to young people and their families. Our team of experts is committed to transforming lives through evidence-based treatment and compassionate support.Job SummaryWe are seeking a skilled Utilization Review Specialist to join our team....
-
Senior Utility Support Specialist
4 weeks ago
Nashville, Tennessee, United States i3 Verticals Management Services, Inc. Full timeJob OverviewWe are seeking a highly skilled Senior Utility Support Specialist to join our team at i3 Verticals Management Services, Inc.The ideal candidate will have a strong background in utility industry and experience working with Agile Methodology.Key ResponsibilitiesWork closely with offshore teams to ensure accuracy and quality of deliverables.Develop...
-
Utilization Review Specialist
2 weeks ago
Nashville, Tennessee, United States Charlie Health Full timeJob SummaryWe are seeking a highly skilled Utilization Review Specialist to join our team at Charlie Health. As a key member of our clinical operations team, you will be responsible for ensuring that our virtual IOP caseload is thoroughly reviewed and managed to provide the best possible outcomes for our patients.In this role, you will work closely with our...
-
Utilization Specialist
2 days ago
Nashville, United States Ascension St. Thomas Behavioral Health Hospital Full timeOverview:Read the overview of this opportunity to understand what skills, including and relevant soft skills and software package proficiencies, are required.Join Ascension Saint Thomas Behavioral Health Hospital in Nashville, Tennessee, a leading provider of behavioral health services. We are actively seeking a compassionate Full-Time Utilization Specialist...
-
Utilization Specialist
5 days ago
Nashville, United States Ascension St. Thomas Behavioral Health Hospital Full timeOverview:Join Ascension Saint Thomas Behavioral Health Hospital in Nashville, Tennessee, a leading provider of behavioral health services. We are actively seeking a compassionate Full-Time Utilization Specialist to enhance our team of dedicated professionals.Renowned for offering a comprehensive continuum of care for adults and seniors, Ascension Saint...
-
Utility Equipment Specialist
2 months ago
Nashville, Tennessee, United States Hornbuckle Plumbing Company, New Installations Full timePosition OverviewCompensation: Pay is commensurate with experience, starting at $25.00 per hour.Key Responsibilities:Proficient in operating various commercial machinery including dump trucks, backhoes, trackhoes, and skid steers.Conduct repairs on existing plumbing systems.Install water and sewer taps along with utility infrastructure.Qualifications:Prior...
-
Senior Utility Support Specialist
1 month ago
Nashville, Tennessee, United States i3 Verticals Full timeJob Title: Utilities Senior Support AnalystJob Summary:We are seeking a highly skilled Utilities Senior Support Analyst to join our Enterprise Support team at i3 Verticals. As a key member of our team, you will be responsible for providing exceptional support to our utility clients, ensuring timely resolution of issues, and collaborating with our offshore...
-
Senior Utility Support Specialist
3 weeks ago
Nashville, Tennessee, United States i3 Verticals Full timeJob Title:Utilities Senior Support AnalystJob Summary:We are seeking a highly skilled Utilities Senior Support Analyst to join our team at i3 Verticals. As a key member of our support team, you will be responsible for providing exceptional support to our utility clients, ensuring timely resolution of issues, and collaborating with our offshore team to...
-
Diagnostic Imaging Specialist
2 months ago
Nashville, Tennessee, United States MLee Healthcare Staffing and Recruiting, Inc Full timeDiagnostic Imaging Specialist At MLee Healthcare Staffing and Recruiting, Inc, we are seeking a skilled Diagnostic Imaging Specialist to join our team at an established hospital in Nashville, TN metroplex. As a Diagnostic Imaging Specialist, you will utilize imaging equipment and soundwaves to form images of various body parts, aiding doctors in diagnosing...
-
Diagnostic Imaging Specialist
1 week ago
Nashville, Tennessee, United States MLee Healthcare Staffing and Recruiting, Inc Full timeDiagnostic Imaging SpecialistMLee Healthcare is seeking a qualified Diagnostic Imaging Specialist to join a dynamic team at an established hospital in the Nashville, TN metroplex. Using imaging equipment and soundwaves to form images of many parts of the body utilized to help doctors diagnose and treat many medical solutions.Key Responsibilities:Utilize...
-
Nashville, Tennessee, United States Phillips & Jordan Full timeJob Title: Foreman (ROW Clearing)We are seeking a highly skilled and experienced Foreman to join our team at Phillips & Jordan, Inc. (P&J), a certified woman-owned, heavy civil and power infrastructure contractor.About UsP&J is a proven innovator, leader, and solution in the industry, with a reputation for taking on challenging projects and successfully...
-
Arabic Language Specialist
2 weeks ago
Nashville, Tennessee, United States LTC Language Solutions Full timeLTC Language Solutions is a leading provider of language services, offering interpreting, translation, and language training for over 31 years. We are currently seeking Arabic Language specialists to work with us as subcontractors, providing interpretation services for government and professional offices in the metro Nashville area.As an Arabic Language...
-
Crisis Intervention Specialist
2 weeks ago
Nashville, Tennessee, United States Family & Children's Services of Central Maryland Full timeCrisis Specialist Job DescriptionWe are seeking a highly skilled and compassionate Crisis Specialist to join our team at Family & Children's Services of Central Maryland. As a Crisis Specialist, you will play a critical role in providing support and guidance to individuals in crisis, utilizing your expertise in crisis intervention and mental health...
-
Child Life Specialist
3 weeks ago
Nashville, Tennessee, United States Vanderbilt University Medical Center Full timeJob Title: Child Life SpecialistVanderbilt University Medical Center is seeking a skilled Child Life Specialist to join our team. As a Child Life Specialist, you will play a vital role in providing direct patient care to children and their families, utilizing developmentally appropriate therapeutic play and education to promote coping and adaptation.Key...
-
AP Specialist
4 weeks ago
Nashville, Tennessee, United States Virtual Full timeAP Specialist Job DescriptionWe are seeking an experienced AP Specialist to join our team in Nashville, TN. The ideal candidate will have 3-5 years of experience in general ledger and account reconciliation, with strong proficiency in Excel and experience with SAP.Key Responsibilities:Reconcile general ledger accounts accurately and in a timely manner.Assist...
-
Production Specialist
2 weeks ago
Nashville, Tennessee, United States FastSigns Full timeJob Summary: We are seeking a skilled Production Specialist to join our team at FASTSIGNS. As a Production Specialist, you will work in a dynamic and creative environment to create and assemble sign and graphic products for various business applications. Your attention to detail and ability to work accurately will be essential in this role.Key...
-
Plumbing Specialist
2 weeks ago
Nashville, Tennessee, United States W3Global Inc Full timeJob Title: Plumbing SpecialistJob Summary:We are seeking a highly skilled Plumbing Specialist to join W3Global Inc. as part of our team. The successful candidate will be responsible for the installation and maintenance of new plumbing systems in commercial buildings.Key Responsibilities: Install plumbing systems according to local building codes and client...
Utilization Specialist
2 months ago
Find out exactly what skills, experience, and qualifications you will need to succeed in this role before applying below.
Join Ascension Saint Thomas Behavioral Health Hospital in Nashville, Tennessee, a leading provider of behavioral health services. We are actively seeking a compassionate Part-Time Utilization Specialist to enhance our team of dedicated professionals.
Renowned for offering a comprehensive continuum of care for adults and seniors, Ascension Saint Thomas strives to deliver empathetic, individualized treatment solutions. If you are passionate about contributing to a top-tier behavioral health facility and making a difference in the lives of those experiencing mental health challenges, we welcome you to apply
Work Schedule: Part-Time - approximately 24-30 hours a week
PURPOSE STATEMENT:
Proactively monitor utilization of services for patients to optimize reimbursement for the facility.
Responsibilities:
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.
OTHER FUNCTIONS:
Perform other functions and tasks as assigned.
Qualifications:
EDUCATION/EXPERIENCE/SKILL REQUIREMENTS:
Required Education: High school diploma or equivalent.
Preferred Education: Associate's, Bachelor's, or Master’s degree in Social Work, Behavioral or Mental Health, Nursing, or a related health field.
Experience: Clinical experience is required, or two or more years' experience working with the facility's population.
Previous experience in utilization management is highly preferred
LICENSES/DESIGNATIONS/CERTIFICATIONS:
Preferred Licensure: LPN, RN, LMSW, LCSW, LPC, LPC-I within the state where the facility provides services; or current clinical professional license or certification, as required, within the state where the facility provides services.
CPR and de-escalation and restraint certification required (training available upon hire and offered by facility.
First aid may be required based on state or facility requirements.
ADDITIONAL REGULATORY REQUIREMENTS:
While this job description is intended to be an accurate reflection of the requirements of the job, management reserves the right to add or remove duties from particular jobs when circumstances
(e.g. emergencies, changes in workload, rush jobs or technological developments) dictate.
We are committed to providing equal employment opportunities to all applicants for employment regardless of an individual’s characteristics protected by applicable state, federal and local laws.
URSPECF
