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Behavioral Health Utilization Review Specialist
1 month ago
We are seeking a highly skilled Utilization Review Coordinator to join our team at Hospital for Behavioral Medicine. As a key member of our clinical team, you will play a critical role in ensuring that our patients receive the highest level of care and support.
Key Responsibilities- Conduct thorough reviews of patient treatment plans to ensure that they are aligned with insurance company requirements.
- Communicate with external case managers and managed care organizations to secure certification and recertification of insurance benefits.
- Collaborate with the treatment team to understand insurance company requirements and advocate for the patient's access to services.
- Chair treatment team meetings and continued stay reviews as indicated.
- Maintain ongoing contact with the attending physician, program manager, nurse manager, and various members of the team.
- Collaborate with the treatment team regarding continued stay and discharge planning issues.
- Interface with program staff to facilitate a smooth transition at the time of transfer or discharge.
- Maintain documentation related to case management activities.
- Assure tracking of insurance reviews, and that reviews are completed in a timely manner.
- Maintain statistical reports and prepare documentation of significant findings.
- Bachelor's degree in nursing or Master's degree from an accredited college or university in social work, mental health or related degree required.
- A minimum of two (2) years experience in a behavioral healthcare setting or managed care company, with experience in patient assessment, treatment planning, utilization management, and/or case management.
- Competitive salary range: $62,400 - $93,600 annually.
- 401(k) + matching.
- Health insurance 100% company-paid.
- Life insurance coverage up to 2x your annual salary.
- Vision insurance.
- Dental insurance.
- Long term disability insurance.
- Paid time off.
- Paid holidays.
- Cafeteria on site + discounted meals.
- Employee engagement events.
- Employee assistance program.
- Employee recognition program.
- Free parking.
Hospital for Behavioral Medicine is a leading provider of exceptional therapeutic care, prioritizing patient comfort and safety. We are committed to accessible care and emphasize availability irrespective of one's ability to pay.
We value a diverse, inclusive workforce and provide equal employment opportunities for all applicants and employees. We do not discriminate on the basis of race, religion, color, national origin, gender, sexual orientation, gender identity or expression, age, marital status, veteran status, disability status, pregnancy, parental status, genetic information, political affiliation, or any other status protected by the laws or regulations in the locations where we operate.
