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Utilization Review Specialist

Company: Strategic Behavioral Health
Location: Harlingen
Posted on: September 16, 2020

Job Description:





Utilization Review Specialist


Job DetailsLevel ExperiencedJob Location Strategic BH - Brownsville - Harlingen, TXPosition Type Full TimeEducation Level 4 Year DegreeTravel Percentage NoneJob Shift DayJob Category NurseDescription Utilization Review Specialist - Palms Behavioral Health

Join US and be a part of a dynamic TEAM!

We Believe in providing the highest quality of behavioral health care through demonstrating compassion, empathy and perseverance for our patients and their entrusting families.

Palms Behavioral Center - is a 94-bed psychiatric acute treatment facility specializing in adolescents and adults. We are seeking an experienced Utilization Review Specialist team member with the professional passion to complement our current team.The Utilization Review Specialist:



  • Facilitates clinical pertinence reviews on all patient admissions and continued stays, retrospective reviews, denial appeals, and completion of certifications.

  • Overall responsibility for inpatient Utilization Review for assigned patients.

  • Interfaces with managed care organizations, external reviewers and other payors.

  • Serves as a member of the multi-disciplinary team supporting the treatment program and assure the delivery of quality treatment to patients and their family members.

  • Works independently and in collaboration with the attending psychiatrist and other members of the clinical / management staff.

  • Self-directed and self-motivating, plans and conducts work with minimal direction, and reports progress of UR efforts to various stakeholders.



    Qualifications




    • Bachelors degree in Social Work or LPN license issued by Texas Board of Nursing

    • Utilization Review experience in an acute inpatient behavioral health care setting is preferred.

    • Through documented work experience understands the interworking of managed-care organizations.

    • Excellent verbal and written communication skills

      Strategic Behavioral Center offers the following benefit and reward options for full time staff:



      • Medical (choice of options), dental and vision insurance

      • Long and short-term disability

      • Paid time off (begins accruing immediately, eligible following 90 days)

      • Purchase discount programs

      • 401(k) with company match

        Note: in support of SBC's quality requirements, we require a post-offer drug screen, physical, criminal background review and conduct original source verification of degrees / certifications of all candidates.

Keywords: Strategic Behavioral Health, Harlingen , Utilization Review Specialist, Other , Harlingen, Texas

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