Utilization Review Specialist

3 weeks ago


Lancaster, United States Acadia Healthcare Full time

The Utilization Review Specialist at Rebound Behavioral Health will be responsible for conducting initial and concurrent reviews while reviewing clinical documentation for the stay of the patient. Rebound Behavioral Health is located in Lancaster, SC and serves the adult patient population who are experiencing an acute behavioral and/or mental health crisis. In the Utilization Review department team members work closely with the nursing, clinical services and providers to ensure the appropriate stay for patients and solid documentation. The position is part-time, 20 hours/week.Essential Functions, include but not limited to:Act as liaison between managed care organizations and the facility professional clinical staff.Conduct reviews, in accordance with certification requirements, of insurance plans or other managed care organizations (MCOs) and coordinate the flow of communication concerning reimbursement requirements.Monitor patient length of stay and extensions and inform clinical and medical staff on issues that may impact length of stay.Conduct quality reviews for medical necessity and services provided.Facilitate peer review calls between facility and external organizations. Initiate and complete the formal appeal process for denied admissions or continued stay.Provide ongoing support and training for staff on documentation or charting requirements, continued stay criteria and medical necessity updates.Educational/Skills/Licensure/Experience Requirements:Bachelor's or Master's degree in social work, behavioral or mental health, nursing or other related health field.Two or more years' experience with the population of the facility and previous experience in utilization management preferred.CPR and de-escalation and restraint certification required (training available upon hire and offered by facility.Equal Opportunity Employer/Protected Veterans/Individuals with DisabilitiesThe contractor will not discharge or in any other manner discriminate against employees or applicants because they have inquired about, discussed, or disclosed their own pay or the pay of another employee or applicant. However, employees who have access to the compensation information of other employees or applicants as a part of their essential job functions cannot disclose the pay of other employees or applicants to individuals who do not otherwise have access to compensation 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 duty to furnish information. 41 CFR 60-1.35(c)



  • Lancaster, United States Acadia Healthcare Inc. Full time

    The Utilization Review Specialist at Rebound Behavioral Health will be responsible for conducting initial and concurrent reviews while reviewing clinical documentation for the stay of the patient. Rebound Behavioral Health is located in Lancaster, SC and serves the adult patient population who are experiencing an acute behavioral and/or mental health crisis....

  • Medical Bill Reviewer

    2 weeks ago


    Lancaster, United States Proassurance Full time

    An exciting opportunity exists to join the ProAssurance family of companies! We are a specialty writer of professional liability, products liability and workers' compensation insurance. With approximately 1,000 team members operating in all 50 states, we are well-positioned to offer career opportunities to individuals interested in professional...


  • Lancaster, Pennsylvania, United States Niagara Bottling Full time

    At Niagara, we're looking for Team Members who want to be part of achieving our mission to provide our customers the highest quality most affordable bottled water.Consider applying here, if you want to: Work in an entrepreneurial and dynamic environment with a chance to make an impact. Develop lasting relationships with great people. Have the opportunity to...

  • Specialist

    2 weeks ago


    Lancaster, United States Crate and Barrel Full time

    We inspire purpose-filled living that brings joy to the modern home. With a team of more than 8,000 associates spanning 130 store and distribution locations across the U.S. and Canada, we achieve together, drive results and innovate to inspire. Drawn together by a shared passion for our customers and a spirit of fun, we deliver high-quality home furnishings...


  • Lancaster, United States Chapman Auto Group Full time

    DescriptionSummary - The Guest Experience Specialist will provide exceptional service and support to the customers throughout their lifecycle within the dealership. Do you enjoy interacting with people? Are you energetic? Do you like a challenge? You may be the perfect fit for our growing team! *No experience necessary *Salary plus bonus *Onsite training ...


  • Lancaster, United States ICU Medical Full time

    Position Summary The Warehouse Specialist II will also be responsible for the following tasks: picking and staging customer orders on the shipping dock, counting and cross checking all orders that are staged for next day delivery, replenishment of the warehouse picking locations, cleaning of the warehouse and individual picking locations. Additionally, the...


  • Lancaster, United States PeoplesBank Full time

    Job DescriptionJob DescriptionPosition SummaryThe Traveling Banking Specialist III (Lancaster/Oregon Pike/York) will serve on the Retail Support team as client service and primary new account and loan representative for the financial centers supported. This position will demonstrate strong client conversational skills utilizing the Bank defined conversation...


  • Lancaster, United States Race Telecommunications LLC Full time

    Job DescriptionJob DescriptionJob Title: OSP Utility Locator TechnicianClassification: Full-Time, Non-Exempt, At-WillReports to: OSP DirectorDepartment: Construction & OSPLocation: In-Field: Lancaster, CA. Location Status: Work will be primarily performed at a designated field worksite location based out of a central Race Communications worksite. Occasional...

  • Customer Experience

    4 days ago


    Lancaster, United States ECORE International Full time

    **Customer Experience - Account Specialist** Ecore - Lancaster, 715 Fountain Avenue, Lancaster, Pennsylvania, United States of America Req #72 Thursday, January 27, 2022 This position is responsible for assisting the Account Managers in the Customer Service Department with order processing and phone support. The Account Specialist will assist all Account...


  • Lancaster, United States SERVPRO of Lancaster East Full time

    **Benefits**: - 401(k) matching - Dental insurance - Health insurance - Paid time off - Vision insurance SERVPRO of Lancaster East is hiring a **Business Development Specialist**! **Benefits** SERVPRO of Lancaster East offers: - Competitive compensation - Superior benefits - Career progression - Professional development And more! As a Business...


  • Lancaster, United States Breakthru Beverage Group Full time

    Overview The Account Development Specialist is responsible for maximizing the sales and marketing of supplier brands to a targeted account base through effective planning, selling, merchandising and communication that permits achievement of company and supplier objectives. This role must maintain strong relationships with the key...


  • Lancaster, United States Lancaster General Health Full time

    Summary Job Description Job Title: Clinical Pharmacy Specialist - Drug Information This position is located in Lancaster, PA. Schedule is semi-flexible, part time hours. Some Tuesdays and Thursdays each month will be required. Details to be discussed further during on-site interview. The Drug Information Clinical Pharmacy Specialist is part-time...


  • Lancaster, United States Pma Financial Network Full time

    Job DescriptionJob DescriptionSummaryCreate a career in a rapidly growing, premier full-service provider of comprehensive financial services to municipalities, school districts and other local government entities. As an Institutional Investment Specialist, you will be instrumental in creating and delivering a unique client experience that defines and...


  • Lancaster, United States Pma Financial Network Full time

    Job DescriptionJob DescriptionSummaryCreate a career in a rapidly growing, premier full-service provider of comprehensive financial services to municipalities, school districts and other local government entities. As an Institutional Investment Specialist, you will be instrumental in creating and delivering a unique client experience that defines and...


  • Lancaster, United States Lancaster General Health Full time

    **Summary** **Job Description** **Job Title: Clinical Pharmacy Specialist - Drug Information** **This position is located in Lancaster, PA.** **Schedule is semi-flexible, part time hours. Some Tuesdays and Thursdays each month will be required. Details to be discussed further during on-site interview.** **The Drug Information Clinical Pharmacy...


  • Lancaster, United States JWCH Institute Full time

    Position Purpose: The HIV Engagement Specialist will assist the Data to Care Team in developing and implementing a client identification and engagement strategy. They will conduct outreach, including in-person field and home visits with clients, establish regular communication to build rapport and provide support. The specialist will also coordinate...

  • Delivery Specialist

    3 days ago


    Lancaster, United States Lancaster County Motors Full time

    **CATEGORY** Sales **DESCRIPTION** Join the Mercedes-Benz of Lancaster Family: Be Our Next **Delivery Specialist** At Mercedes-Benz of Lancaster, we believe in making every drive extraordinary. As a **Delivery Specialist**, you won’t just hand over keys; you’ll open doors to unparalleled experiences. **Your Role**: - Connect: Help clients...


  • Lancaster, United States Independent Options, LLC Full time

    Locations in **Lancaster, Kennett Square, West Chester PA**. **Independent Options, LLC.** is looking for qualified _**Behavior Specialist Consultant**_**, CNAs** in **LANCASTER COUNTY**, **CHESTER COUNTY, DAUPHIN COUNTY, DELAWARE COUNTY, PA** who are motivated to make a difference in the lives of individuals with intellectual disabilities (IDD) whom are...


  • Lancaster, United States Cirba Solutions US Inc Full time

    Job DescriptionJob DescriptionGeneral Description The Capital Project Controls Specialist will assist Project Managers with the processes involved in managing capital project costs and schedule. The person in this role will be responsible for the control services and reporting to enable successful and efficient delivery of the Cirba Solutions capital plan....


  • Lancaster, United States SERVPRO of Lancaster East Full time

    Job DescriptionJob DescriptionBenefits:401(k) matchingDental insuranceHealth insurancePaid time offVision insurance SERVPRO of Lancaster East is hiring a Business Development Specialist!BenefitsSERVPRO of Lancaster East offers:Competitive compensationSuperior benefitsCareer progressionProfessional developmentAnd more!As a Business Development Representative,...