Utilization Review Case Manager & Patient Advocate

Ventura Services Florida; Zachary (LA); On-site; USD 52,000 - 72,000; Full time

Job summary

Seaside Health System is seeking a Utilization Review (Case Manager) to organize and provide information for pre-certifications and authorizations from insurers. This non-exempt role reports to Clinical Supervisors and is based in a clinical office setting.

Responsibilities include direct patient care support, UR functions, coordinating with the treatment team, and documenting caseload psychoeducation groups. Must have a Bachelor's degree and CPR/CPI certification.

Qualifications

• Must have Bachelor’s degree in related field.
• Must maintain CPR and CPI certification.
• Experience with Utilization Review in behavioral health and government assistance preferred.
• Good verbal and written communication skills.
• Computer literate.
• Completes assignments accurately, in a timely manner, and within procedural guidelines.

Responsibilities

• Provides direct patient care by assisting patients with all aspects of case management needs.
• Assists patient and treatment team in UR functions – Obtaining pre-certifications and authorizations from insurance companies to ensure treatment coverage and payment.
• Participates as an active member of treatment team.
• Facilitates psychoeducation groups and document on assigned caseload.
• Other duties as assigned/required.

Skills

Verbal and written communication

Computer literacy

Time management

Education

Bachelor’s degree in related field

CPR certification

CPI certification

Job description

Seaside Health System is seeking a Utilization Review (Case Manager) to organize and provide information for pre-certifications and authorizations from insurers. This non-exempt role reports to Clinical Supervisors and is based in a clinical office setting.

Responsibilities include direct patient care support, UR functions, coordinating with the treatment team, and documenting caseload psychoeducation groups. Must have a Bachelor's degree and CPR/CPI certification.