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UTILIZATION REVIEW SPEC - PRN - (230606)

Universal Health Services


Location:
AUSTIN, TX
Date:
04/20/2018
2018-04-202018-05-19
Job Code:
4933
Universal Health Services
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Job Details

Deltek Talent Management - UTILIZATION REVIEW SPEC - PRN - (230606)

Job Details


UTILIZATION REVIEW SPEC - PRN - (230606)

Facility Name
AUSTIN LAKES HOSPTAL
Location
AUSTIN, TX 78705 US (Primary)
Career Area
Professional
Category
Other, Registered Nurse (RN), Social Worker
Job Description

Austin Lakes Hospital located in beautiful and vibrant Austin, TX has a UTILIZATION REVIEW SPECIALIST- PRN opportunity. Austin Lakes Hospital offers a continuum of psychiatric services for adults 18 and up with acute mental health needs in a confidential, caring environment that promotes crisis resolution, positive self awareness, personal growth and problem solving skills. The cornerstone of our treatment rests on exceptional mental health services and clinical excellence. Our continuum of care includes inpatient and outpatient psychiatric services to stabilize symptoms of depression, anxiety and other behavioral health disorders.

This position will cover for FT staff taking time off and/or during periods of high UR activity.

RESPONSIBILITIES include but are not limited to:

• Performs reviews for appropriateness of admission and continued stay.

• Serves as liaison with medical staff and other clinical departments.

• Contacts third-party payers to obtain authorizations for admission and continued stay.

• Appeals reimbursement denials.

Job Requirements

Ability to communicate ideas both verbally and in writing. Ability to maintain confidentiality. Thorough knowledge of utilization review principles and procedures including state, federal, and JC regulations, data collections, techniques, medical analysis, insurance payer systems and cost containment methods.Ability to communicate ideas both verbally and in writing. Ability to maintain confidentiality. Thorough knowledge of utilization review principles and procedures including state, federal, and JC regulations, data collections, techniques, medical analysis, insurance payer systems and cost containment methods.

Licensed Mental Health Professional; LPC, LMSW, LCSW or RN.

Required: Minimum of two (2) years professional experience in a health care setting, preferably inpatient. Experience in UR.

Preferred: Five years experience in mental health in an inpatient facility.  Five years UR experience.

Must be able to stoop, kneel, crouch, reach, and stand for sustained periods of time. Must be able to walk, pull, lift objects from lower to higher position of horizontally from position; finger, grasp, feel sizes, shapes, temperatures and textures. Light work most of the time, exerting up to 25 pounds of force occasionally and/or up to 10 pounds of force frequently and occasionally medium work that is exerting up to 50 pounds of force occasionally and/or up to 20 pounds of force frequently.  Visual acuity adequate to perform essential functions. The worker is not substantially exposed to adverse environmental conditions. Must be able to work with several distractions including light conversation. Must be able to deal with aggressive, hostile and irrational behavior of patients calmly and therapeutically. Must be able to respond calmly in situations concerning frustrated and angry patients and/or family members.

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