Behavioral Health Utilization Review Specialist
5 days ago
At St. Clare's Health, we are committed to delivering high-quality, compassionate care to our patients. As a Utilization Review Coordinator, you will play a critical role in ensuring that our patients receive the necessary care and services to achieve optimal health outcomes.
Responsibilities:- Conduct thorough reviews of patient medical records to determine medical necessity and intensity of service
- Communicate with external case managers and managed care organizations to obtain pre-authorization and manage concurrent reviews
- Assist the treatment planning team in understanding insurance requirements and complete UR audits for billing compliance
- Bachelor's degree in Social Work, Psychology, or other health-related field
- Knowledge of DSM 5 diagnosis and medical necessity criteria for behavioral health levels of care
- Knowledge of basic psychological and medical terminology
We are an equal employment opportunity employer and prohibit discrimination against any applicant or employee based on race, color, sex, sexual orientation, gender identity, religion, national origin, age, disability, military status, genetic information, or any other protected category. We are committed to creating a diverse and inclusive work environment that values and respects all individuals.
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Behavioral Health Utilization Review Specialist
3 weeks ago
Boonton, New Jersey, United States St. Clare's - Boonton Full timeAbout the RoleWe are seeking a highly skilled Behavioral Health Utilization Review Specialist to join our team at St. Clare's - Boonton. As a key member of our healthcare team, you will play a critical role in ensuring the quality and resource management of patients admitted to our inpatient behavioral health units.ResponsibilitiesConduct thorough reviews of...
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Behavioral Health Utilization Review Specialist
4 weeks ago
Boonton, New Jersey, United States St. Clare's - Boonton Full timeAbout the RoleAt St. Clare's - Boonton, we are committed to delivering high-quality, patient-centered care. As a Behavioral Health Utilization Review Specialist, you will play a critical role in ensuring that our patients receive the necessary resources and support to achieve optimal health outcomes.Key ResponsibilitiesConduct thorough reviews of patient...
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Boonton, New Jersey, United States St. Clare's - Boonton Full timeJob Title: Behavioral Health Utilization Review CoordinatorAt St. Clare's Health, we are committed to delivering high-quality, compassionate care to our patients. As a Behavioral Health Utilization Review Coordinator, you will play a critical role in ensuring that our patients receive the necessary care and services to achieve optimal...
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Behavioral Health Utilization Review Specialist
2 weeks ago
Boonton, New Jersey, United States St. Clare's - Boonton Full timeOverviewAt St. Clare's Health, our dedicated team of professionals is committed to delivering high-quality, compassionate care to our patients. As a member of Prime Healthcare, St. Clare's Health is seeking a skilled Utilization Review Coordinator to join its award-winning team.ResponsibilitiesThe Utilization Review Coordinator will be responsible for...
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Behavioral Health Utilization Review Specialist
2 weeks ago
Boonton, New Jersey, United States St. Clare's - Boonton Full timeOverviewAt St. Clare's Health, our dedicated team of professionals is committed to delivering high-quality, compassionate care to our patients. As a member of Prime Healthcare, St. Clare's Health is seeking a skilled Utilization Review Coordinator to join its award-winning team.ResponsibilitiesThe Utilization Review Coordinator will be responsible for...
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Behavioral Health Utilization Review Specialist
2 weeks ago
Boonton, New Jersey, United States St. Clare's - Boonton Full timeOverviewAt St. Clare's Health, our dedicated team of professionals is committed to delivering high-quality, compassionate care to our patients. As a member of Prime Healthcare, St. Clare's Health is seeking a skilled Utilization Review Coordinator to join its award-winning team.ResponsibilitiesThe Utilization Review Coordinator will be responsible for...
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Behavioral Health Utilization Review Coordinator
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Boonton, New Jersey, United States St. Clare's - Boonton Full timeAbout St. Clare's - BoontonSt. Clare's - Boonton is a leading healthcare provider dedicated to delivering high-quality, patient-centered care. Our team of professionals is committed to upholding our core values of quality, compassion, and community.Job SummaryWe are seeking a skilled Behavioral Health Utilization Review Coordinator to join our team. The...
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Boonton, New Jersey, United States St. Clare's - Boonton Full timeOverviewAt St. Clare's Health, our dedicated team of professionals is committed to delivering high-quality, compassionate care to our patients. As a member of Prime Healthcare, St. Clare's Health is seeking experienced Registered Nurses to join its award-winning team.ResponsibilitiesAs a Registered Nurse on our Child and Adolescent Behavioral Health Unit,...
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