Utilization Review Specialist

Responsibilities

Utilization Review Specialist

Rivendell Behavioral Health Services is an 80-bed full-service behavioral healthcare acute care facility located in Benton, AR, that has been providing quality health care to the residents of Arkansas since 1985. Rivendell Behavioral Health Services has been offering hope to individuals, families, and communities for over 30 years. Rivendell Behavioral Health Services is the leader in providing quality mental health and addiction treatment services. Our commitment to care includes developing integrated delivery systems through partnerships with medical surgical hospitals, community mental health centers, educational institutions, managed care organizations, local health professionals and agencies. Rivendell Behavioral Health Services strives to set the standard for excellence in the field of behavioral health care and maintains its leadership role by treating each patient as a respected individual of our community.

Rivendell Behavioral Health Services of Arkansas is seeking a Utilization Review Specialist for full time status. The Utilization Review Specialist ensures that inpatient admissions & continued hospital stays are medically necessary and that patients receive the highest quality of health care in the most resourceful manner.

Key roles of the Utilization Review Specialist include but are not limited to the following :

• Reviews documentation to support severity of illness, intensity of services, need for current level of treatment, and notifies supervisor of any deficiencies.
• Conducts admissions and continued-stay reviews with payors (Medicaid, Medicare, private insurance) for authorizations and reports to treatment team and supervisor any certification problems.
• Reviews the denial and appeals process for assigned caseload by identifying cases with potential for denial, identifies actions, which need to occur to avoid denials and follows through with process for appealing actual denials.
• Is responsible for assuring that all disciplines (nursing, therapy, recreational therapy, physician, education) are documenting quality progress notes as required. Any instances of noted deficiencies will be reported immediately to supervisor.
• Communicates with the clinicians and other departments regarding certification or payor issues that impact length of stay. Is able to communicate patient's payor status to physician to include quality issues and necessity for doctor to doctor review. Is able to communicate available options for patients.
• Maintains a good working relationship with referral sources as well as knowledge of community resources. May occasionally act as a resource to others relating to aftercare options.
• Strong communication skills with the ability to build a good working rapport with customers, clinicians, physicians, and staff are imperative to a having success as a Utilization Review Specialist.

As a full time employee at Rivendell Behavioral Health you are eligible for our Comprehensive Benefits Package including :

Challenging and rewarding work environment

Competitive Compensation

Excellent Medical, Dental, Vision, and Prescription Drug Plan

Generous Paid Time Off

401(K) with company match and discounted stock plan

Career development opportunities within UHS and its Subsidiaries

Qualifications

Bachelor's degree (B. A.) from four-year college or university; or one to two years related experience and / or training; or equivalent combination of education and experience. Current licensure as a Nurse with at least one year psychiatric experience or Licensed Social Worker with LMSW or LCSW is preferred. Computer skills necessary.

Universal Health Services, Inc. (UHS) is one of the nation's largest and most respected health care 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 83,000 employees. The UHS business strategy is to build or purchase health care 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.

At UHS, we're looking for exceptional people who share our vision and values, who share our focus on hard work, enthusiasm, teamwork, loyalty, trust and cooperation. We've embraced these traits and built a team of employees who consistently work to achieve the highest level of service excellence. People are our most valuable resource at UHS as we are committed to providing high quality acute care and behavioral health services to residents of the communities we serve. We are equally committed to offering our employees unlimited opportunity in an environment that encourages professional development.

UHS 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 UHS 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 UHS. No fee will be paid in the event the candidate is hired by UHS as a result of the referral or through other means.

EEO Statement

All UHS subsidiaries are committed to providing an environment of mutual respect where equal employment opportunities are available to all applicants and teammates. UHS subsidiaries are equal opportunity employers and as such, openly support and fully commit to recruitment, selection, placement, promotion and compensation of individuals without regard to race, color, religion, age, sex (including pregnancy, gender identity, and sexual orientation), genetic information, national origin, disability status, protected veteran status or any other characteristic protected by federal, state or local laws.

We believe that diversity and inclusion among our teammates is critical to our success.

Notice

At UHS and all our subsidiaries, our Human Resources departments and recruiters are here to help prospective candidates by matching skillset and experience with the best possible career path at UHS and our subsidiaries. We take pride in creating a highly efficient and best in class candidate experience. During the recruitment process, no recruiter or employee will request financial or personal information (Social Security Number, credit card or bank information, etc.) from you via email. The recruiters will not email you from a public webmail client like Hotmail, Gmail, Yahoo Mail, etc. If you are suspicious of a job posting or job-related email mentioning UHS or its subsidiaries, let us know by contacting us at : https : / / uhs.alertline.com or 1-800-852-3449.