Director of Utilization Review/Case Mgt

Freedom Behavioral Hospital of Monroe • Monroe, LA

6d • Onsite

About The Position

Freedom Behavioral Hospital of Monroe has an immediate opening for a Utilization Review representative. At Freedom, we put patient care first in all we do, and our people make that possible. We know that your best work happens when you live your best life and share your unique talents. If fulfilling your career potential in an environment where you know you have made a difference in the lives of others sounds appealing, this is the job for you.

The Utilization Review representative provides appropriate care and assesses and interprets data based on the patient's status and the age specific needs of the individual. Analyzes patient records to determine legitimacy of admission, treatment, and length of stay to comply with governmental and insurance company requirements. This position is responsible for review of precertification requests for medical necessity, referring to the medical director those that require additional expertise. The Utilization Review representative will review clinical information for concurrent reviews, extending the length of stay for patients as appropriate and provide appropriate consultation and referral to Case Management/Social Services personnel.

Requirements

• Effective verbal communication skills
• Effective organizational skills
• Effective interpersonal skills
• Analytical problem solving skills
• Ability to read and comprehend written instructions; ability to follow verbal instructions
• Proficient knowledge of PC computers
• Basic understanding of DSM V diagnostic criteria
• Basic understanding of medical and psychiatric diagnoses and conditions
• Post-offer drug test and federal background investigation

Nice To Haves

• Psychology major preferred or nursing education
• Nursing License
• Social Worker License
• 1+ years coordinating utilization review and discharge planning activities

Responsibilities

• Provides appropriate care and assesses and interprets data based on the patient's status and the age specific needs of the individual.
• Analyzes patient records to determine legitimacy of admission, treatment, and length of stay to comply with governmental and insurance company requirements.
• Reviews precertification requests for medical necessity, referring to the medical director those that require additional expertise.
• Reviews clinical information for concurrent reviews, extending the length of stay for patients as appropriate.
• Provides appropriate consultation and referral to Case Management/Social Services personnel.

What This Job Offers

• Job Type: Full-time
• Career Level: Director
• Education Level: No Education Listed