Remote Utilization Review Clinician - Behavioral Health

Valley Hope Addiction Treatment & Recovery; Leawood (KS); À distance; USD 64 000 - 95 000; Plein temps

Avantages offerts par ce poste

Medical coverage up to 85% of premiums

Dental & vision plans

Up to 27 days PTO

8 paid holidays

Paid parental leave

401(k) with employer match

Tuition assistance

Student loan repayment support

PSLF eligible employer

EAP

Résumé du poste

Valley Hope Addiction Treatment & Recovery is seeking an Utilization Review Clinician for a full-time, remote-capable role. The position supports review and coordination of clinical utilization and payer expectations for patient admissions with external payment options.

The role serves as a clinical resource for determining admission appropriateness and continued stays, gathering required information for insurance authorization, and maximizing clinically appropriate patient days.

Qualifications

• Master's level licensed clinician or nurse with state licensure.
• Three years of behavioral healthcare clinical counseling, nursing, or clinical case management experience.

Responsabilités

• Review and coordinate clinical utilization and external payer expectations for each patient admission with external payment options.
• Act as a clinical resource to determine appropriateness of admission and continued stays.
• Gather required clinical information and report to insurance providers to obtain authorization for continued stay.
• Maximize certified patient days that are clinically appropriate and available as benefits.
• Assist with insurance pre-certifications for patients admitted to treatment.
• Appeal denials of certified days when in the patient and Valley Hope's best interests.
• Communicate patient status with the business office, nursing, and counselors.
• Review medical necessity guidelines for managed care partners and assist with discharge planning information.

Connaissances

Clinical counseling

Utilization review

Communication

Formation

Master's level licensed clinician or nurse (LCSW/LSW/LMFT/RN/LPN)

Licensed to practice in state of employment

Description du poste

Valley Hope Addiction Treatment & Recovery is seeking an Utilization Review Clinician for a full-time, remote-capable role. The position supports review and coordination of clinical utilization and payer expectations for patient admissions with external payment options.

The role serves as a clinical resource for determining admission appropriateness and continued stays, gathering required information for insurance authorization, and maximizing clinically appropriate patient days.