Utilization Review Specialist

3 weeks ago

Ambler, Pennsylvania, United States UHS Full time
About the Role

The Horsham Clinic is seeking a skilled and detail-oriented Utilization Review Specialist to join our team. As a Utilization Review Specialist, you will play a critical role in evaluating medical records to determine the severity of patient illnesses and determining the appropriate level of care.

Key Responsibilities
  • Evaluate medical records to determine the severity of patient illnesses and determine the appropriate level of care.
  • Act as a liaison between patients, hospitals, and insurance companies to negotiate and advocate for patients' length of stay and level of care.
  • Oversee utilization review activities with other departments to ensure reimbursement for services provided by the hospital.
Requirements
  • Masters Level Education/ MSW
  • RN License in the state of Pennsylvania
  • Licensure in LSW/ LSCW
  • Demonstrated working knowledge of behavioral mental health, nursing clinical practices, and management
  • Experience in interviewing patients and families to obtain clinical information and acute symptoms
  • Highly developed written and verbal communication skills
  • 3 or more years of experience in a behavioral health setting
  • Ability to plan, direct, and monitor others' activities with demonstrated leadership abilities that contribute to a positive work environment
  • Proficiency with common computer-based applications such as electronic mail, word processing, and various databases
About UHS

One of the nation's largest and most respected providers of hospital and healthcare services, Universal Health Services, Inc. (UHS) has built an impressive record of achievement and performance. During the year, UHS was again recognized as one of the World's Most Admired Companies by Fortune; and listed in Forbes ranking of America's Largest Public Companies.

Equal Employment Opportunity

All UHS subsidiaries are committed to providing an environment of mutual respect where equal employment opportunities are available to all applicants and teammates. UHS subsidiaries are equal opportunity employers and as such, openly support and fully commit to recruitment, selection, placement, promotion, and compensation of individuals without regard to race, color, religion, age, sex (including pregnancy, gender identity, and sexual orientation), genetic information, national origin, disability status, protected veteran status, or any other characteristic protected by federal, state, or local laws.

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