Healthcare Utilization Manager
2 days ago
Sanctuary Recovery Centers is seeking a Healthcare Utilization Manager to join our team. As a key member of our operations team, you will play a critical role in reviewing admissions and utilization authorizations throughout our facilities. Your primary responsibility will be to review clinical documentation, communicate with various sites, and secure and process authorizations for inpatient, residential, and other services that require payor authorization.
You will also be responsible for securing and monitoring pre-certifications, concurrent reviews, retro reviews, and appeals to ensure timely and appropriate care for our members. In addition, you will serve as a communication liaison between our organization and assigned payors, ensuring seamless coordination of care and authorizations.
We offer a competitive salary range of $55,000 - $65,000 per year, depending on experience. If you are a motivated and organized professional with a passion for healthcare, we encourage you to apply for this exciting opportunity.
Key Responsibilities- Pre-Certification and Authorization: Ensure that Sanctuary Recovery Center's has obtained authorization for medically necessary services provided to patients.
- Communication and Liaison: Serve as a communication liaison between Sanctuary Recovery Centers and assigned payors, ensuring seamless coordination of care and authorizations.
- Patient Flow Management: Coordinate the flow of patients from medical management teams, complete referrals in the EMR, collect medical records for completeness, identify availability of appropriate bed placements, and ensure timely review for acceptance/notification of denials.
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