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Utilization Review Specialist

2 months ago

Ambler, Alaska, United States Foundations for Living Full time
Job Title: Utilization Review Specialist

We are seeking a skilled Utilization Review Specialist to join our team at Foundations for Living. As a Utilization Review Specialist, you will play a critical role in evaluating medical records to determine the severity of patients' illnesses and determining the appropriate level of care.

Responsibilities:
  • Evaluate medical records to determine the severity of patients' illnesses and determine the appropriate level of care.
  • Act as a liaison between patients and hospital with 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
  • 3 or more years of experience in behavioral health setting
  • Ability to plan, direct, and monitor others' activities with demonstrated leadership abilities that contribute to a positive work environment.

We offer a competitive salary and benefits package, as well as opportunities for professional growth and development. If you are a motivated and detail-oriented individual with a passion for healthcare, we encourage you to apply for this exciting opportunity.