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UR Analyst - Women's Center - (243068)

Universal Health Services


Location:
PALM SPRINGS, CA
Date:
11/16/2017
2017-11-162017-12-15
Job Code:
4030
Universal Health Services
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Job Details

Deltek Talent Management - UR Analyst - Women's Center - (243068)

Job Details


UR Analyst - Women's Center - (243068)

Facility Name
Michael's House
Location
PALM SPRINGS, CA 92262 US (Primary)
Career Area
Professional
Category
Accounting, Rehabilitation Physical Therapist (RPT)
Job Description

Foundations Recovery Network (FRN) is the premier provider of integrated treatment for co-occurring addiction and mental health concerns, offering residential and outpatient services nationwide. At each facility, we focus on patient-centered care and an individualized approach, upholding a high standard of innovative treatment and compassionate attention to each patient’s needs. We are committed to providing and promoting evidence-based treatment for individuals with co-occurring disorders through clinical services, education, and research. Our purpose is to create lifetime relationships for long-term recovery. Everything we do is designed to support recovery in a comprehensive way, addressing the needs of the whole person—physically, emotionally, mentally, and spiritually. We provide the foundation; you build the life. Michael’s House Treatment Center is a refuge of healing and recovery nestled at the base of the San Jacinto Mountains in Palm Springs, California. For many years, our warm, welcoming atmosphere has provided individuals with the support, compassion, and education designed to treat their specific recovery needs. With a wealth of expertise, our caring treatment team members empower you to reach your recovery goals and find the healthy, wholesome, and fulfilling life that you deserve. FRN is currently seeking a Utilization Review Analyst, to be responsible for reviewing client insurance benefits and ascertaining level of care (LOC) pre-certifications. The ideal candidate will have the ability to inspire our clients’ confidence in both our staff and the FRN Model of Treatment. Do you have a passion for working with patients with co-occurring disorders and chemical dependence? Do you want to be a part of a team of highly skilled individuals, driven by the goal of helping people through life-changing recovery? Do you have the desire to serve as a Brand Ambassador to FRN? If so, then this could be the role you’ve been dreaming about! This positionis located at Foundations Recovery Network’s facility, Michael’s House, in Palm Springs, California.

Job Requirements

Essential Duties and Responsibilities

  • Reviews and understands insurance information provided by the Call Center, determines which benefits are available to client, and clarifies discrepancies or confusion
  • Completes a thorough review of all clinical documentation; meets with the client upon admission or soon thereafter to complete pre-certification information, as needed
  • Determines what LOC the client meets and what ASAM (American Society of Addiction Medicine) and/or health plan criteria support that LOC based on client’s benefits
  • Once a care manager is established, contacts health plan provider and requests most appropriate LOC for client
  • Documents in system, and in a paper file, the request made and authorization approval number/contact information
  • Reviews weekly UR update information
  • Attends Flash Meetings as assigned
  • Performs all other duties as required or assigned

 

Knowledge, Skills, and Abilities

  • Ability to inspire client confidence in the FRN Staff and the FRN Model of Treatment.
  • Ability to consistently demonstrate, through conduct and communications, the stability required to effectively assist patients and their family members through the FRN Model of Treatment
  • Excellent verbal and written communication skills required
  • Must have high level of interpersonal skills, as this position continually requires demonstrated professionalism, tact, and diplomacy
  • Specific knowledge of substance abuse and/or mental health treatment on a clinical level
  • Ability to understand insurance benefits and follow insurance protocols within appropriate time frames
  • Ability to learn levels of care guidelines and medical necessity criteria
  • Must have strong knowledge of a variety of computer software applications in word processing and spreadsheets (MS Word, Excel)
  • Excellent organizational skills, with the ability to prioritize workload and meet deadlines
  • Ability to pay continual attention to detail in documenting files
  • Understands need for and maintains appropriate confidentiality at all times when interacting with patients, residents, families, visitors, referral sources, and all other contacts
  • Exhibits excellent customer relations skills as evidenced by supportive and constructive communication with all contacts including co-workers, patients, residents, visitors, families, and referral sources
  • Must possess a current, valid driver’s license

 

EDUCATION/EXPERIENCE

  • LVN/RN level in Nursing or Master’s degree in psychology, MFT, social work, or related field preferred
  • Minimum of 2 years’ experience working in a substance dual diagnosis facility with client contact
  • Minimum of 1 year experience working in a managed care position
  • Licensure and CADC certification in addictions preferred

 

If you meet the above requirements and are looking for a rewarding career, please take a moment to share your background and experience with us by applying online.  FRN offers competitive compensation, commensurate with experience, and benefits programs including medical, dental, life insurance, and 401K.

FRN is not accepting unsolicited assistance from search firms for this employment opportunity.  Please, no phone calls or emails.  All resumes submitted by search firms to any employee at FRN via email, the Internet, or in any form and/or method without a valid written search agreement in place for this position will be deemed the sole property of FRN.  No fee will be paid in the event the candidate is hired by FRN as a result of the referral or through other means.

EQUAL OPPORTUNITY EMPLOYER

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