Clinical Utilization Review Coordinator

2 weeks ago


Tucson, Arizona, United States Acadia Healthcare Full time

KEY RESPONSIBILITIES:
Offer expert consultation and direction concerning patient admissions and the duration of stay to various insurance providers.
Obtain necessary authorizations from insurance entities for inpatient care and maintain ongoing authorization throughout the patient's treatment period.
Assess the utilization program to ensure adherence to relevant regulations, policies, and procedures.
Analyze clinical documentation from denied cases against established criteria to ascertain if the provided documentation supports the requested treatment.
Oversee staff management, which includes recruitment, professional development, training, performance evaluation, and effective communication to guarantee smooth departmental operations.

EDUCATIONAL BACKGROUND/EXPERIENCE/SKILL SET:
An associate's degree is mandatory. A bachelor's or master's degree in social work, behavioral or mental health, nursing, or a related health discipline is preferred.
A minimum of four years of clinical experience with the relevant patient population and prior experience in utilization management is essential.

Acadia Healthcare is an Equal Opportunity Employer, welcoming applications from Protected Veterans and Individuals with Disabilities.

The contractor will not terminate or discriminate against employees or applicants based on inquiries about, discussions of, or disclosures regarding their own pay or that of another employee or applicant.

However, employees with access to compensation information as part of their essential job functions are prohibited from disclosing the pay of other employees or applicants to individuals without access to such information, unless the disclosure is (a) in response to a formal complaint or charge, (b) in furtherance of an investigation, proceeding, hearing, or action, including an investigation conducted by the employer, or (c) consistent with the contractor's legal obligations to provide information.

41 CFR c)

  • Tucson, Arizona, United States Radiology Full time

    About the RoleRadiology Ltd. is seeking an experienced Clinical Review Specialist to join our team. As a key member of our radiology team, you will be responsible for the timely and accurate pre-exam review and coordination of clinical information pertaining to radiology exams.Key ResponsibilitiesProspectively analyzes and reviews orders and clinical...


  • Tucson, Arizona, United States Northwest Healthcare Home Health - Tucson Full time

    Join Our Team as a Clinical Care Coordinator!At Northwest Healthcare Home Health - Tucson, we are dedicated to fostering a culture of compassion, inclusion, and trust. Our mission revolves around building meaningful relationships with our patients, their families, our colleagues, and the communities we serve.As a Clinical Care Coordinator, you will...


  • Tucson, Arizona, United States Northwest Medical Center Full time

    Job SummaryWe are seeking a skilled and compassionate RN Case Manager to join our team at Northwest Medical Center. As a key member of our Case Management department, you will play a vital role in coordinating patient care and ensuring seamless transitions between healthcare services.Key Responsibilities:Coordinate patient care through an interdisciplinary...

  • Chief Nursing Officer

    19 hours ago


    Tucson, Arizona, United States Clinical Management Consultants Full time

    Job SummaryClinical Management Consultants is seeking a highly experienced Associate Chief Nursing Officer to join our team. As a key member of our leadership team, you will be responsible for overseeing the quality of nursing care and the effective coordination of nursing services.Key ResponsibilitiesPlan, direct, and coordinate the day-to-day operations...


  • Tucson, Arizona, United States Nesco Resource Full time

    Job Overview:As a Clinical Study Associate (CSA) at Nesco Resource, you will play a crucial role within the Clinical Services Management team, providing essential support to the Clinical Services Project Management Team. Your responsibilities will encompass a variety of tasks related to Sponsor's Monitoring Visits, including Study/site Qualification and...


  • Tucson, Arizona, United States JFCS of Southern Arizona Full time

    Position OverviewThe Clinical Support Coordinator plays a vital role in evaluating participant needs and orchestrating treatment services for individuals enrolled in our programs.KEY RESPONSIBILITIESEngages in the intake process by conducting initial demographic assessments and confirming insurance coverage.Facilitates referrals for urgent support and...


  • Tucson, Arizona, United States Planet Pharma Full time

    Position Overview:As a Clinical Research Coordinator (CRC) at Planet Pharma, you will be an integral member of the Clinical Services Management team, providing essential support to the Clinical Services Project Management Team. Your role will encompass a diverse range of responsibilities associated with Sponsor's Monitoring Visits, including Study/site...


  • Tucson, Arizona, United States Software Guidance & Assistance, Inc. (SGA, Inc.) Full time

    Company Overview: Software Guidance & Assistance, Inc. (SGA, Inc.) is a distinguished provider of technology and resource solutions, committed to delivering exceptional service. As a women-owned enterprise, we pride ourselves on our personalized approach to solving complex IT challenges.Position Summary: We are seeking a Clinical Research Coordinator for a...


  • Tucson, Arizona, United States Roche and Genentech Full time

    Job OverviewPosition Summary:As a Clinical Research Coordinator (CRC), you will play a vital role within the Clinical Services Management team, providing essential support to the Clinical Services Project Management Team. Your responsibilities will encompass a diverse range of tasks associated with Sponsor Monitoring Visits, including Study/site...


  • Tucson, Arizona, United States Northwest Medical Center Full time

    Position Overview:This is a Full-Time role, operating during Day shifts within the Case Management department at Northwest Medical Center.Incentives:A sign-on bonus of $xx,000 is available for qualified, experienced RNs.Key Responsibilities:- Facilitate service coordination through a collaborative interdisciplinary approach, ensuring a comprehensive clinical...


  • Tucson, Arizona, United States Pima Community College Full time

    Position Overview:As an integral part of the Health Professions Division, Pima Community College is seeking to enhance its pool of qualified faculty to instruct courses in Clinical Research Coordination. This role is designed for part-time educators who are passionate about fostering student success and are committed to providing equitable and inclusive...


  • Tucson, Arizona, United States Revel IT Full time

    To Apply for this Job Click HereRevel IT is seeking a Clinical Study Associate to join our dynamic team. In this role, you will be an integral part of the Clinical Services Management team, providing essential support to the Clinical Services Project Management Team through a variety of tasks associated with Sponsor's Monitoring Visits and Pharma Partner's...


  • Tucson, Arizona, United States The Joint Chiropractic Full time

    Job DescriptionWe are seeking a highly motivated and goal-oriented individual to join our team as a Chiropractic Clinic Coordinator. As a key member of our team, you will be responsible for providing exceptional patient services and contributing to the success of our wellness center.Key Responsibilities:Provide World-Class Service: Greet patients, check them...

  • Gas Utility Plumber

    5 days ago


    Tucson, Arizona, United States Centuri Group, Inc. Full time

    About the RoleWe are seeking a skilled Gas Utility Plumber to join our team at Centuri Group, Inc. as an Infrastructure Specialist. In this role, you will play a critical part in ensuring the safe and efficient delivery of natural gas services to our customers.Key ResponsibilitiesExamine and test gas piping systems to ensure safety and quality standards are...


  • Tucson, Arizona, United States Faribault Foods Full time

    Job SummaryFaribault Foods, a leading food manufacturing company, is seeking an experienced and safety-conscious Utilities Technician to join our line maintenance team. We manufacture, can, and supply a wide range of food products, including whole beans, refried beans, and enchilada sauces.Key ResponsibilitiesMaintain and repair all company utility,...


  • Tucson, Arizona, United States Northwest Medical Center Full time

    Job SummaryWe are seeking a highly skilled and experienced RN Clinical Care Coordinator to join our team at Northwest Medical Center. As a key member of our Stroke Program, you will play a vital role in overseeing the daily operations and accreditation of our Center of Excellence.Key ResponsibilitiesEnsure efficient use of hospital resources and coordinate...


  • Tucson, Arizona, United States Banner Health Full time

    About This RoleWe are seeking a highly skilled Registered Nurse RN Case Manager to join our Care Coordination team at Banner Health. As a key member of our team, you will play a critical role in ensuring that patients receive the necessary services and care in a timely and efficient manner.Key ResponsibilitiesManage individual patients across the healthcare...

  • Nurse Coordinator

    29 minutes ago


    Tucson, Arizona, United States Tucson Medical Center Full time

    About the RoleTucson Medical Center is seeking a skilled and compassionate Nurse Coordinator to join our team. As a key member of our clinical staff, you will play a vital role in ensuring the highest level of patient care and satisfaction.Key ResponsibilitiesCoordinate patient care planning with other disciplines, utilizing the principles of the nursing...

  • Clinical Pharmacist

    2 weeks ago


    Tucson, Arizona, United States Northwest Houghton Hospital Full time

    Clinical Pharmacist OpportunitySign-On Bonus: $10,000Student Loan Repayment Assistance: Up to $10,000As a Clinical Pharmacist at Northwest Houghton Hospital, you will be integral in delivering exceptional care to our patients. Our pharmacy team benefits from a comprehensive package that includes health insurance, retirement plans, flexible work schedules,...

  • Sales Coordinator

    16 hours ago


    Tucson, Arizona, United States Goodmans Full time

    About the RoleWe are seeking a highly skilled and experienced Sales Coordinator to join our team at Goodmans. As a Sales Coordinator, you will play a critical role in coordinating the efforts of each order from quote through punch list, ensuring seamless execution and exceptional customer experiences.Key ResponsibilitiesBe the primary point of contact for...