Utilization Review Clinician: Care Coordination & Authorization

Universal Health Services; Sacramento (CA); On-site; USD 70,000 - 90,000; Full time

Benefits offered by this job

Competitive pay

Medical, dental, vision, prescription

401(k) with company match

Education assistance

Career development

Job summary

Heritage Oaks Hospital is part of the UHS family and located in northern Sacramento. The Utilization Review Clinician will manage and monitor patient resource utilization, acting as a liaison between payors, the business office, and the treatment team to ensure appropriate and efficient care and reimbursement.

Requirements include an MSW degree, and either one year of external review communications or four years of clinical psychiatric experience, plus prior authorizations or case management

Qualifications

• Master's degree in social work, mental health or a related field.
• A minimum of one year experience with communication with external review organizations or four years direct clinical experience in a psychiatric or mental health setting.
• Prior experience with prior authorizations or Case Management is preferred.
• Licensure: MSW degree
• Additional Requirements: Trained in Handle with Care (HWC) within 30 days; CPR certification required.

Responsibilities

• Manages, reviews and monitors utilization of resources related to the patient to maximize effectiveness of care.
• Acts as liaison between payors, the business office, and treatment team to assist in care and reimbursement.
• Reviews with payor sources and receives authorization for services through all levels of care and aftercare.
• Attends treatment planning meetings and coordinates care considering available financial resources.

Education

Master's degree in social work, mental health or a related field

Job description

Heritage Oaks Hospital is part of the UHS family and located in northern Sacramento. The Utilization Review Clinician will manage and monitor patient resource utilization, acting as a liaison between payors, the business office, and the treatment team to ensure appropriate and efficient care and reimbursement.

Requirements include an MSW degree, and either one year of external review communications or four years of clinical psychiatric experience, plus prior authorizations or case management