Utilization Review Manager: Optimize Care & Reimbursement

Acadia Healthcare; Conway (AR); Presencial; USD 60.000 - 80.000; Jornada completa

Descripción de la vacante

Acadia Healthcare in Conway, AR seeks a qualified nurse to monitor service utilization and secure patient authorizations for inpatient treatment, ensuring alignment with payer requirements and facility policies.

The role collaborates with admissions, case management, and clinical staff to review documentation, manage length of stay, and drive compliant utilization practices while supporting staff development.

Formación

• Current licensure as an RN or LPN in the state where the facility provides services.
• CPR and de-escalation and restraint certification required (training available upon hire).
• First aid may be required based on state or facility requirements.

Responsabilidades

• Provide consultation and guidance regarding admissions and patient length of stay to a variety of payers.
• Secure authorizations with insurance companies for inpatient treatment and continue to obtain authorizations for duration of patient stay.
• Evaluate the utilization program for compliance with regulations, policies and procedures.
• Review clinical documentation from denied stays against criteria to determine if documentation is adequate for requested treatment.
• Provide staff management to including hiring, development, training, performance management and communication to ensure effective and efficient department operation.

Educación

RN or LPN license

Descripción del empleo

Acadia Healthcare in Conway, AR seeks a qualified nurse to monitor service utilization and secure patient authorizations for inpatient treatment, ensuring alignment with payer requirements and facility policies.

The role collaborates with admissions, case management, and clinical staff to review documentation, manage length of stay, and drive compliant utilization practices while supporting staff development.