Clinical Resource Manager

1 week ago


Sacramento, California, United States UHS Full time
Job Summary

Sierra Vista Hospital is seeking a full-time Clinical Resource Manager (MSW, MFT, MA, RN, LVN) for the Utilization Management Department.

We are looking for a dedicated professional who is passionate about working in a mental health environment and wants to join a team of healthcare professionals committed to serving our patients.

Key Responsibilities
  • Manage, review, and monitor the utilization of patient-related resources and maximize the effectiveness of care by evaluating clinical appropriateness.
  • Act as a liaison between payers, the business office, and the treatment team, providing information and feedback to ensure optimal patient care and reimbursement.
  • Review with payers and receive authorization for the type and volume of services through all levels of care and post-care review.
Requirements
  • Education: A bachelor's degree from an accredited university in nursing or a master's degree in social work, mental health, or a related field is preferred.
  • Experience: A minimum of one (1) year of experience with communication with external review organizations or comparable entities or four (4) years of direct clinical experience in a psychiatric or mental health setting.
  • Licensure: RN, LCSW, MFT, MSW, LVN/LPT, or applicable licensure.

CPI training is required within the first 30 days of employment. Training is provided by Sierra Vista Hospital.



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