On-Site Utilization Review Case Manager

Dallas Behavioral Healthcare Hospital; DeSoto (TX); On-site; USD 65,000 - 85,000; Full time

Benefits offered by this job

Medical, dental, vision insurance

401(k) plan

Job summary

Dallas Behavioral Healthcare Hospital in Texas seeks a Utilization Review Case Manager to coordinate authorization for inpatient admissions with insurers and managed care systems. You will review authorization steps and monitor processes to ensure patients access full benefits.

The role requires nursing or related clinical training, knowledge of medical terminology and managed care, and the ability to work on-site with strong attention to deadlines and records management.

Qualifications

• Must pass background check, drug screen, and physical.
• Knowledge of managed care environment and admission/continued stay criteria.
• Familiarity with medical terminology and treatment modalities.

Responsibilities

• Conduct admission reviews.
• Conduct concurrent and extended stay reviews.
• Prepare and submit appeals to third party payors.
• Maintain records of the Utilization Review Department.
• Uphold the Organization's ethics and customer service standards.

Skills

Time management

Attention to detail

Multitasking

Strong communication

Education

Nursing or related healthcare degree

Job description

Dallas Behavioral Healthcare Hospital in Texas seeks a Utilization Review Case Manager to coordinate authorization for inpatient admissions with insurers and managed care systems. You will review authorization steps and monitor processes to ensure patients access full benefits.

The role requires nursing or related clinical training, knowledge of medical terminology and managed care, and the ability to work on-site with strong attention to deadlines and records management.