Behavioral Health Utilization Review Specialist
17 hours ago
At St. Clare's Health, we strive to deliver exceptional care to our patients and communities. As a Behavioral Health Utilization Review Specialist, you will play a vital role in ensuring the quality and resource management of our inpatient behavioral health units.
Responsibilities include contacting external case managers and managed care organizations for pre-authorization, concurrent reviews, and appeals/denials management. You will also assist the treatment planning team in understanding insurance requirements and complete UR audits for billing compliance.
The ideal candidate will possess a Bachelor's degree in Social Work, Psychology, or a related field, with knowledge of DSM 5 diagnosis and medical necessity criteria for behavioral health levels of care. A Master's degree and one year of experience in direct care mental health, case management, discharge planning, or nursing management are preferred.
We are an equal employment opportunity employer and prohibit discrimination against any applicant or employee based on protected categories.
Responsibilities:
- Quality and resource management of inpatient behavioral health units
- Contacting external case managers and managed care organizations
- Assisting treatment planning team with insurance requirements
- Completing UR audits for billing compliance
Qualifications:
- Bachelor's degree in Social Work, Psychology, or related field
- Knowledge of DSM 5 diagnosis and medical necessity criteria
- Preferred: Master's degree and one year of experience in direct care mental health
-
Boonton, New Jersey, United States St. Clare's - Boonton Full timeOverview:At St. Clare's Health, our dedicated team of professionals is committed to delivering high-quality, compassionate care to our patients and their families. As a member of Prime Healthcare, St. Clare's Health is seeking a skilled Behavioral Health Utilization Review Specialist to join its award-winning team. The successful candidate will be...
-
Behavioral Health Utilization Review Specialist
2 weeks ago
Boonton, New Jersey, United States St. Clare's - Boonton Full timeJob Title: Behavioral Health Utilization Review CoordinatorAt St. Clare's Health, we are committed to delivering high-quality, compassionate care to our patients. As a Behavioral Health Utilization Review Coordinator, you will play a critical role in ensuring that our patients receive the necessary care and services to achieve optimal...
-
Behavioral Health Utilization Review Specialist
3 weeks ago
Boonton, New Jersey, United States St. Clare's - Boonton Full timeOverviewAt St. Clare's Health, our dedicated team of professionals is committed to delivering high-quality, compassionate care to our patients. As a member of Prime Healthcare, St. Clare's Health is seeking a skilled Utilization Review Coordinator to join its award-winning team.ResponsibilitiesThe Utilization Review Coordinator will be responsible for...
-
Behavioral Health Utilization Review Specialist
3 weeks ago
Boonton, New Jersey, United States St. Clare's - Boonton Full timeOverviewAt St. Clare's Health, our dedicated team of professionals is committed to delivering high-quality, compassionate care to our patients. As a member of Prime Healthcare, St. Clare's Health is seeking a skilled Utilization Review Coordinator to join its award-winning team.ResponsibilitiesThe Utilization Review Coordinator will be responsible for...
-
Behavioral Health Utilization Review Specialist
3 weeks ago
Boonton, New Jersey, United States St. Clare's - Boonton Full timeOverviewAt St. Clare's Health, our dedicated team of professionals is committed to delivering high-quality, compassionate care to our patients. As a member of Prime Healthcare, St. Clare's Health is seeking a skilled Utilization Review Coordinator to join its award-winning team.ResponsibilitiesThe Utilization Review Coordinator will be responsible for...
-
Boonton, New Jersey, United States St. Clare's - Boonton Full timeOverviewAt St. Clare's Health, our dedicated team of professionals is committed to delivering high-quality, compassionate care to our patients and communities.We are seeking a skilled Utilization Review Coordinator to join our award-winning team, which includes CMS 5-Star Rated hospitals and a network of healthcare facilities serving Morris, Warren, and...
-
Behavioral Health Utilization Review Specialist
2 weeks ago
Boonton, New Jersey, United States St. Clare's - Boonton Full timeJob Title: Utilization Review CoordinatorAt St. Clare's Health, we are committed to delivering high-quality, compassionate care to our patients. As a Utilization Review Coordinator, you will play a critical role in ensuring that our patients receive the necessary care and services to achieve optimal health outcomes.Responsibilities:Conduct thorough reviews...
-
Behavioral Health Specialist
4 days ago
Boonton, New Jersey, United States Community Hope Full timeMake a Difference in Someone's Life Every DayCommunity Hope, Inc. is seeking a dedicated and compassionate Behavioral Health Specialist to join our team. As a key member of our community-based transitional housing residence, you will provide direct adult rehabilitative support services to consumers, promoting their independence and well-being.Key...
-
LPN Behavioral Health Specialist
3 weeks ago
Boonton, New Jersey, United States Prime Healthcare Full timeOverviewAt Prime Healthcare, we are committed to delivering high-quality, compassionate care to our patients and communities. Our team of dedicated professionals is passionate about making a difference in the lives of others.We are seeking a skilled Licensed Practical Nurse (LPN) to join our Behavioral Health team at Saint Clare's Health. As a member of our...
-
LPN Behavioral Health Specialist
4 weeks ago
Boonton, New Jersey, United States Saint Clare's Health System Full timeLPN Behavioral Health Job DescriptionAt Saint Clare's Health System, we are committed to providing high-quality, compassionate care to our patients. As a Licensed Practical Nurse (LPN) in our Behavioral Health department, you will play a vital role in delivering exceptional patient care.Responsibilities:Provide direct and indirect patient care services,...
-
LPN Behavioral Health Specialist
2 days ago
Boonton, New Jersey, United States Saint Clare's Health System Full timeLPN Behavioral Health Job DescriptionAt Saint Clare's Health System, we are committed to delivering high-quality, compassionate care to our patients and their families. As a Licensed Practical Nurse (LPN) in our Behavioral Health department, you will play a vital role in providing exceptional patient care and contributing to the success of our...
-
LPN Behavioral Health Specialist
4 weeks ago
Boonton, New Jersey, United States Saint Clare's Health System Full timeLPN Behavioral Health Job DescriptionAt Saint Clare's Health System, we are committed to providing high-quality, compassionate care to our patients. As a Licensed Practical Nurse (LPN) in our Behavioral Health department, you will play a vital role in delivering exceptional patient care and contributing to a positive work environment.Responsibilities:Provide...
-
Behavioral Health Specialist
3 days ago
Boonton, New Jersey, United States Community Hope Full timeJob Title: Behavioral Health CounselorCommunity Hope, Inc. is seeking a qualified Behavioral Health Counselor to join our team. As a Behavioral Health Counselor, you will provide direct adult rehabilitative support services to consumers in a community-based transitional housing residence.Job Summary:The Behavioral Health Counselor will provide on-site...
-
LPN - Behavioral Health Specialist
2 days ago
Boonton, New Jersey, United States Saint Clare's Health System Full timeJob Title: LPN - Behavioral Health (CCIS)At Saint Clare's Health System, we are committed to providing high-quality, compassionate care to our patients and their families. We are seeking a skilled Licensed Practical Nurse (LPN) to join our team in a Behavioral Health role.About the Role:The LPN will provide direct and indirect patient care services, working...
-
LPN Behavioral Health Specialist
2 weeks ago
Boonton, New Jersey, United States Prime Healthcare Full timeOverviewAt Prime Healthcare, we are committed to delivering high-quality, compassionate care to our patients. As a member of our dedicated team, you will have the opportunity to make a meaningful difference in the lives of others.Our network of hospitals and healthcare facilities, including Saint Clare's Health, has received numerous quality awards and...
-
Behavioral Health Nurse
2 weeks ago
Boonton, New Jersey, United States Saint Clare's Health System Full timeJob Title: Behavioral Health RNAt Saint Clare's Health System, we are committed to providing high-quality, compassionate care to our patients and their families. We are seeking a skilled and dedicated Registered Nurse to join our Behavioral Health team.About the Role:As a Behavioral Health RN, you will be responsible for providing direct patient care to...
-
Behavioral Health Nurse
2 weeks ago
Boonton, New Jersey, United States Saint Clare's Health System Full timeJob Title: Behavioral Health RNAt Saint Clare's Health System, we are committed to providing high-quality, compassionate care to our patients and their families. We are seeking a dedicated and experienced Registered Nurse to join our Behavioral Health team.About the Role:As a Behavioral Health RN, you will be responsible for providing direct patient care to...
-
Behavioral Health Nursing Director
3 days ago
Boonton, New Jersey, United States St. Clare's - Boonton Full timeJob Title: Behavioral Health Nursing ManagerAt St. Clare's - Boonton, we are committed to providing high-quality, compassionate care to our patients. As a Behavioral Health Nursing Manager, you will play a critical role in leading our team of dedicated professionals in delivering exceptional patient care.Responsibilities:Supervise and assess patient care,...
-
Behavioral Health Nurse
3 weeks ago
Boonton, New Jersey, United States Saint Clare's Health System Full timeAbout Saint Clare's Health SystemAt Saint Clare's Health System, our dedicated team of professionals is committed to delivering high-quality, compassionate care to our patients and their families.We are proud to be part of Prime Healthcare, a leading healthcare organization that shares our values of quality, compassion, and community.Job SummaryWe are...
-
Behavioral Health Nurse
4 weeks ago
Boonton, New Jersey, United States Saint Clare's Health System Full timeAbout the RoleWe are seeking a dedicated and compassionate Registered Nurse to join our Behavioral Health team at Saint Clare's Health System. As a member of our interdisciplinary treatment team, you will play a vital role in providing high-quality care to patients with mental health conditions.ResponsibilitiesProvide direct patient care, including...