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UTILIZATION REVIEW SPECIALIST- FT

Southwest Healthcare System
EDEN PRAIRIE, Minnesota, US
Full-time

Responsibilities As we look back on Pride Institute’s almost 38-year history of providing our clients with an inclusive and accepting place for recovery through evidence-based treatment for substance abuse, sexual health and mental health, we realize that Pride Institute’s services and advocacy are needed now more than ever! Our Residential Treatment Center (RTC) staff in Eden Prairie and our Intensive Outpatient Program (IOP) staff in Uptown Minneapolis understand the issues the LGBTQIA+ community face, and our mission is to give clients the tools needed for addiction and mental health recovery.

For the past four years, Pride Institute has been recognized as one of Newsweek’s Best Addiction Treatment Centers. We have also been honored by the MINNESOTA’S Best STAR TRIBUNE READERS’ CHOICE survey every year since its inception in with the silver award in the Recovery / Treatment Center category.

We strive to provide the best client-centered care by employing and developing highly qualified staff trained in working specifically with the LGBTQIA+ community and dedicated to service excellence.

Pride Institute is seeking a dynamic and talented Utilization Review Specialist to serve within the Utilization Management team.

The Utilization Review Specialist is responsible for overseeing the Utilization Review Program for In Patient and Outpatient services.

This includes the implementation of case management scenarios, consulting with all services to ensure the provision of an effective treatment plan for all patients, overseeing the response to requests for services and interfacing with managed care organizations, external reviewers, and other payers.

  • Please visit to submit your application today! Qualifications MINIMUM QUALIFICATIONS REQUIRED : Education : Degree in nursing, social work, mental health / behavioral sciences, or related field required;
  • Master's degree preferred. Experience : A minimum of five years’ direct clinical experience in a psychiatric or mental health treatment setting;

one year of managing a related function preferred. Experience in patient assessment, family motivation, treatment planning and communication with external review organizations or comparable entities.

Licensure : L.P.C., L.V.N., R.N., L.M.S.W. or applicable license. Additional Requirements : Knows and understands Minnesota Statutes Chapters G, E (Child Maltreatment), and A, .

and . (Vulnerable Adults). Thorough knowledge of CARF, state and federal regulatory requirements. ADDITIONAL INFORMATION ABOUT THE PRIDE INSTITUTE : We are a subsidiary of Universal Health Services, Inc.

UHS). One of the nation’s largest and most respected providers of hospital and healthcare services, UHS has built an impressive record of achievement and performance.

Growing steadily since its inception into an esteemed Fortune corporation, annual revenues were $13.4 billion in . During the year, UHS was again recognized as one of the World’s Most Admired Companies by Fortune;

and listed in Forbes ranking of America’s Largest Public Companies. Headquartered in King of Prussia, PA, UHS has approximately 94, employees and continues to grow through its subsidiaries, operating acute care hospitals, behavioral health facilities, outpatient facilities and ambulatory care access points, an insurance offering, a physician network and various related services located all over the U.

S. states, Washington, D.C., Puerto Rico and the United Kingdom.

30+ days ago
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