Clinical Utilization Specialist

3 days ago


Santa Rosa, California, United States Sacramento Behavioral Healthcare Hospital Full time

Overview

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Sacramento Behavioral Healthcare Hospital is a leading provider of mental health services in Northern California. We are dedicated to delivering exceptional care and treatment options for adolescents and adults with mental health and co-occurring conditions.

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About the Position

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We are seeking a skilled Clinical Utilization Specialist to join our team. As a Clinical Utilization Specialist, you will work as part of a multi-disciplinary treatment team reviewing patient care and treatment options for both inpatient and outpatient services.

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Responsibilities

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Key responsibilities include conducting admission reviews/pre-authorizations, concurrent stay reviews, payment appeals, recordkeeping, medical necessity assessments, collaboration with clinical teams, denial risk identification, and providing staff training and education.

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Requirements

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The ideal candidate will have a current license as an LCSW, ASW, MFT, LMFT, RN, LPT, LVN, or LPC, and preferably a Master's degree in Social Work, Behavioral Science, or a related field. Demonstrated knowledge of healthcare service delivery systems and third-party reimbursement, experience working in managed care environments, and strong understanding of admission and discharge functions are required.

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Benefits

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We offer a competitive salary range of $45.00-$65.00 per hour, along with a comprehensive benefits package including health insurance, vision insurance, dental insurance, 401(k) retirement plan, healthcare spending account, life insurance, short-term and long-term disability, PTO plan, discounted cafeteria meal plan, and tuition reimbursement.

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Company Overview

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Santa Rosa Behavioral Healthcare Hospital has been serving the community since 2016, offering 144 acute psychiatric inpatient beds and a wide range of mental health services. Our hospital is committed to providing high-quality care and treatment options for patients and their families.


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