Utilization Assistant

1 day ago


El Paso Texas, United States Rio Vista Behavioral Health Full time

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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