What are the responsibilities and job description for the Utilization Management Specialist I position at SUN Behavioral Delaware?
This job was posted by https://joblink.delaware.gov : For more
information, please see: https://joblink.delaware.gov/jobs/1488378
Position Summary
Responsible for the coordination of case management strategies pursuant
to the Case Management process. Assists and coordinates care of the
patient from pre-hospitalization through discharges. Responsible for
assisting with authorization of admissions to hospital. Processes
retroactive reviews and appeals, copies needed documentation and writes
retro/appeal letters for insurance companies to ensure coverage for
patient admissions. Conducts follow up calls with insurance companies to
ensure coverage for patient admissions. Participates in performance
improvement activities. Attends 80% of staff meetings. Coordinates care
for patient through communication with Physicians, Nurse Practitioners,
Clinical Services, Nursing, Assessment and Referrals Department.
information, please see: https://joblink.delaware.gov/jobs/1488378
Position Summary
Responsible for the coordination of case management strategies pursuant
to the Case Management process. Assists and coordinates care of the
patient from pre-hospitalization through discharges. Responsible for
assisting with authorization of admissions to hospital. Processes
retroactive reviews and appeals, copies needed documentation and writes
retro/appeal letters for insurance companies to ensure coverage for
patient admissions. Conducts follow up calls with insurance companies to
ensure coverage for patient admissions. Participates in performance
improvement activities. Attends 80% of staff meetings. Coordinates care
for patient through communication with Physicians, Nurse Practitioners,
Clinical Services, Nursing, Assessment and Referrals Department.