Utilization Review Specialist FT Peak Behavioral Health
Company: Peak Behavioral Health
Location: Santa Teresa
Posted on: May 11, 2022
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Job Description:
The Utilization Review Specialist is responsible for reviewing
of assigned admissions, continued stays, utilization practices and
discharge planning according to approved clinically valid criteria
and meeting the daily deadlines to obtain authorizations and
complete other pertinent processes.Education / Licensure:Candidate
will possess an accredited master's degree in social work, mental
health or a related field, or be licensed as a Registered Nurse in
the state of NM. One year's experience with communication with
external review organizations or comparable entities and direct
clinical experience in a psychiatric or mental health setting is
preferred. Skills:1) Comprehensive understanding of the admission,
concurrent, continued stay, and retrospective reviews using the
established hospital criteria. 2) Ability to communicate
professionally and effectively, orally, in person, and in writing,
with multidisciplinary team members, managed care organizations and
business office, providing needed information in a logical, concise
manner using technical language that accurately describes patient's
condition and need for hospitalization. 3) Working knowledge of
payor resources and financial planning 4) Ability to organize and
prioritize workload to meet deadlines, orchestrate a myriad of
activities and to manage multiple priorities within complex and
changing systems; 5) Able to self-regulate and facilitate helpful
management dynamics during stressful situations. Additional
Requirements: Timely renew and maintain an active registered
nursing license, cardiopulmonary resuscitation for healthcare
professionals certification, professional skills verification and
PI177396584
Keywords: Peak Behavioral Health, El Paso , Utilization Review Specialist FT Peak Behavioral Health, Healthcare , Santa Teresa, Texas
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