Utilization Review Specialist FT Peak Behavioral Health

Company: Peak Behavioral Health
Location: Santa Teresa
Posted on: May 11, 2022

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