Utilization Assistant
1 day ago
Job Summary:
The Utilization Assistant - Clinical Support Specialist will provide administrative support to the Utilization department at Rio Vista Behavioral Health. This role will be responsible for performing pre-certification and negotiating continued stay with third-party payers, gathering data to support case management activities, and coordinating discharge planning with the clinical team.
Key Responsibilities:
- Perform pre-certification and negotiate continued stay with third-party payers.
- Gather data to support case management activities, including presentation of gathered data and case notes.
- Coordinate discharge planning with the clinical team, maintain CRM database with discharge information, and follow up.
- Present case information and the needs of third-party payers to relevant stakeholders.
- Assist in admissions review, concurrent reviews, and discharge planning.
- Assist physicians in peer review by serving as an information resource, gathering data to support review, and scheduling peer review.
- Inform management about the status of current patients and document utilization activities as instructed.
- Participate in performance improvement activities.
Qualifications:
- High school diploma or equivalent required.
- Current certification as a Registered Addiction Specialist, certified Substance Abuse Counselor, or similar certification preferred.
Company Overview:
Rio Vista Behavioral Health is committed to providing equal employment opportunities to all applicants for employment regardless of an individual's characteristics protected by applicable state, federal, and local laws.
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