Strategic Utilization Review & Case Management Director

Freedom Behavioral; Monroe (LA); Presencial; USD 52.000 - 62.000; Jornada completa

Descripción de la vacante

Freedom Behavioral Hospital of Monroe seeks a Utilization Review representative to assess patient status, interpret data, and ensure compliance with governmental and insurer requirements. The role includes reviewing admissions, treatments, and length of stay as well as precertification requests and referral of complex cases to medical leadership.

Ideal candidates have 1+ years in utilization review or discharge planning, with strong communication and analytical skills, and the ability to work

Formación

• Psychology major preferred or nursing education.
• Nursing license or social worker license may be relevant.
• 1+ years coordinating utilization review and discharge planning activities.
• Post-offer drug test and background check required.

Responsabilidades

• Review patient records to determine admission validity, treatment, and length of stay in line with governmental and insurer requirements.
• Evaluate precertification requests for medical necessity and refer complex cases to the medical director.
• Perform concurrent reviews and assess need to extend length of stay.
• Provide consultation and referrals to Case Management/Social Services as needed.

Conocimientos

Verbal communication

Organizational skills

Interpersonal skills

Analytical problem solving

Educación

Psychology major or nursing education

Herramientas

PC computers

Descripción del empleo

Freedom Behavioral Hospital of Monroe seeks a Utilization Review representative to assess patient status, interpret data, and ensure compliance with governmental and insurer requirements. The role includes reviewing admissions, treatments, and length of stay as well as precertification requests and referral of complex cases to medical leadership.

Ideal candidates have 1+ years in utilization review or discharge planning, with strong communication and analytical skills, and the ability to work