Utilization & Reimbursement Specialist

Acadia; Magee (MS); On-site; USD 40,000 - 60,000; Full time

Job summary

Acadia is seeking a dedicated professional to serve as a liaison between managed care organizations and clinical staff in Magee, Mississippi. The ideal candidate will have at least a high school diploma, clinical experience, and knowledge of utilization management. Responsibilities include monitoring patient services, conducting quality reviews, and providing training to staff. This role offers an opportunity to impact patient care and optimize facility reimbursement.

Qualifications

• High school diploma or equivalent is required.
• Preferred education includes a degree in Social Work, Behavioral/Mental Health, or Nursing.
• Clinical experience is required or two years' experience working with the facility's population.

Responsibilities

• Act as liaison between managed care organizations and facility staff.
• Conduct reviews of insurance plans and coordinate communication.
• Monitor patient length of stay and extend stays as needed.
• Gather statistical information for facility leadership.
• Conduct quality reviews for medical necessity.

Skills

Clinical experience

Experience with facility's population

Knowledge of utilization management

Education

High school diploma or equivalent

Associate's degree in Social Work or related field

Bachelor's or Master's degree in related field

Job description

Acadia is seeking a dedicated professional to serve as a liaison between managed care organizations and clinical staff in Magee, Mississippi. The ideal candidate will have at least a high school diploma, clinical experience, and knowledge of utilization management. Responsibilities include monitoring patient services, conducting quality reviews, and providing training to staff. This role offers an opportunity to impact patient care and optimize facility reimbursement.