What are the responsibilities and job description for the Utilization Review Specialist position at Acadia Behavioral Health (Pioneer Behavioral Health)?
Employment Type: Full-Time
Hours Per Week: 40
ESSENTIAL FUNCTIONS:
- Provide consultation and guidance regarding admissions and patient length of stay to a variety of payers.
- Secure authorizations with insurance companies for inpatient treatment and continue to obtain authorizations for duration of patient stay.
- Evaluate the utilization program for compliance with regulations, policies and procedures.
- Review clinical documentation from denied stays against criteria to determine if documentation is adequate for requested treatment.
- Provide staff management to including hiring, development, training, performance management and communication to ensure effective and efficient department operation.
- This is an on-site position. Non- Remote
- EDUCATION/EXPERIENCE/SKILL REQUIREMENTS:
- Associate's degree required. Bachelor's or master’s degree in social work, behavioral or mental health, Nursing or other related health field preferred.
- Four or more year's clinical experience with the population of the facility and previous experience in utilization management required.
DIR - UTILIZATION REVIEW / MGMT
UHS -
TUCSON, AZ
