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Utilization Review Specialist -Full Time-

Universal Health Services


Location:
ORLANDO, FL
Date:
06/23/2017
2017-06-232017-07-22
Job Code:
221094
Universal Health Services
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Job Details





Utilization Review Specialist -Full Time-

Job Code:  221094
Facility: University Behavioral Center
Location: ORLANDO, FL US
Region:
Travel Involved: None
Job Type: Full Time
Job Level: 
Minimum Education Required: Master's Degree 
Skills: Health Care -> Behavioral Health
 
Category: Allied Health
FTE: 1.0
Position Summary:


Universal Health Services, Inc. (UHS) is one of the nation's largest and most respected healthcare management companies, operating through its subsidiaries acute care hospitals, behavioral health facilities and ambulatory centers nationwide. Founded in 1978, UHS subsidiaries now have more than 65,000 employees. The UHS business strategy is to build or purchase healthcare properties in rapidly growing markets and create a strong franchise based on exceptional service and effective cost control. Our success comes from a responsive management style and a service philosophy based on integrity, competence and compassion

The below information establishes the core qualifications and day to day job functions of this position.

  • Conduct concurrent and extended stay reviews on appropriate day and/or specified time

  • Prepare and submit appeals to third party payors, effectively coordinating collection of all pertinent data to support the hospital and patient’s position

  • Maintain and update logs of review and maintain other appropriate records of the Utilization Review department

  • Stay abreast of applicable UR trends

  • Communicate pertinent third party payors issues to Physician and treatment team

  • Attend daily treatment team meetings to discuss acuity issues, third party payors needs and gather information for reviews

  • Work independently in gathering information for reviews from the patient record, taking the initiative to seek information from members of the treatment team

  •  Understand and communicate insurance information to team members, including benefits and levels of care offered

  • Perform internal utilization reviews as indicated

  • Prepare any reports assigned or requested by Director of Utilization Review

 
Requirements

 

Education: Masters in Social Work, Psychology, Psychological Counseling, Mental Health Counseling, Psychiatric Nursing, or BSN.

 

Licenses: Valid and current active license for Social Work, Psychiatric Nursing, BSN, Psychological Counseling, Psychology, or Mental Health Counseling.

Professional associating membership:  Valid membership for Social Work and Psychiatric Nursing.

Relevant Work Experience: Two or more years of experience in the health field.


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