Utilization Specialist - Behavioral Health (Onsite, SC)

Acadia Healthcare; South Carolina; In loco; USD 46.000 - 87.000; Tempo pieno

Vantaggi offerti da questo lavoro

MSW/ASN RN Sign-On Bonus

BSN RN Sign-On Bonus

Descrizione del lavoro

Rebound Behavioral Health Hospital in Lancaster, SC is seeking qualified healthcare professionals for an on-site role. The position offers competitive pay and sign-on bonuses for MSN RN and BSN RN candidates. Pay rate ranges from $22 to $42 per hour, depending on experience and qualifications.

The role focuses on utilization management, reimbursement coordination, and ensuring medical necessity across care episodes, with opportunities for growth and professional development.

Competenze

• Required Education: High school diploma or equivalent.
• Preferred Education: Associate's, Bachelor's, or Master’s degree in Social Work, Behavioral or Mental Health, Nursing, or a related health field.
• Experience: Clinical experience is required, or two or more years' experience working with the facility's population. Previous experience in utilization management is preferred.

Mansioni

• Act as liaison between managed care organizations and the facility professional clinical staff.
• Conduct reviews of insurance plans or other managed care organizations and coordinate reimbursement requirements.
• Monitor patient length of stay and inform staff on issues impacting stay.
• Develop statistics and narratives on utilization, non-certified days, discharges and quality of services.
• Conduct quality reviews for medical necessity and services.
• Facilitate peer review calls between facility and external organizations.
• Initiate and complete the formal appeal process for denied admissions or continued stay.
• Assist admissions with pre-certifications of care.
• Provide ongoing staff training on documentation, continued stay criteria and medical necessity updates.
• Perform other functions as assigned.

Formazione

High school diploma or equivalent

Associate's, Bachelor's, or Master’s degree in Social Work, Behavioral or Mental Health, Nursing, or related health field

Descrizione del lavoro

Rebound Behavioral Health Hospital in Lancaster, SC is seeking qualified healthcare professionals for an on-site role. The position offers competitive pay and sign-on bonuses for MSN RN and BSN RN candidates. Pay rate ranges from $22 to $42 per hour, depending on experience and qualifications.

The role focuses on utilization management, reimbursement coordination, and ensuring medical necessity across care episodes, with opportunities for growth and professional development.