UR Case Manager

Alvarado Parkway Institute • La Mesa, CA

13h • Onsite

About The Position

Alvarado Parkway Institute (API) is a free-standing psychiatric hospital in La Mesa, California with three Intensive Outpatient/Partial Hospitalization Programs. API provides comprehensive adult inpatient behavioral health and addictive disorders services in a 66-bed hospital setting. API is committed to improving the mental health and well-being of our community and is San Diego County's leading provider of comprehensive mental health and substance abuse care. API offers a variety of Outpatient Services designed to assist patients in functioning at the highest level, including Partial Hospitalization services and Intensive Outpatient services. These programs emphasize symptom management, community integration, and prevention of hospitalization or re-hospitalization. Value-added services enhance the patient's treatment experience. API is currently seeking a qualified individual to join our team as a UR Case Manager. The UR Case Managers are responsible for monitoring and ensuring the appropriate allocation of hospital resources. The Utilization Review / Case Management (UR/CM) Department addresses appropriate utilization, over-utilization, under-utilization, and inefficient use of resources. UR Case Managers need to be knowledgeable about psychiatric symptoms, behaviors, and diagnoses. The UR/CM Department works closely with the treatment team and ensures that all documentation meets regulatory requirements. Strong communication and organizational skills are required. Must be able to multitask and function well under stress. To be considered for employment, an application must be completed online at https://apibhs.com/careers.

Requirements

• High school, - preferably college -, level reading, writing, and math skills
• Excellent telephone usage skills and strong verbal skills
• Knowledge of health care service delivery systems and third-party reimbursement
• Understanding of admission and discharge function
• Familiarity with medical terminology, diagnostic terms and treatment modalities
• Knowledge of medical record keeping
• Strong interpersonal, organizational, evaluative, and time management skills
• Policy interpretation skills
• Familiarity with applicable standards and regulations
• Able to comprehend psychiatric evaluations, consults, lab results, etc.
• Flexibility
• Attention to detail
• Responsiveness to deadlines
• Assertiveness, persistence, and persuasiveness
• Able to work with minimal direction or supervision
• Background/Reference Check & Licensure/Certification
• Completion of a satisfactory background and reference checks.
• Employee signed employment non-compete/confidentiality agreement
• Individuals whose position may require licensure, registration or certification must maintain such as current and valid.
• It is the employee's responsibility to send updated copies to Human Resources before the expiration date.
• It is the employee's responsibility to notify Human Resources of any changes or proposed changes in status to licensure, registration, or certification.
• Failure to do so could result in employee suspension.
• Covid-19 and Flu Vaccinations; Medical
• Provide a copy of COVID-19 Vaccination OR have an Exemption Request (Deferred Pregnancy, Medical, or Religious) approved by the API HR Director; and those who have an approved Exemption must undergo weekly COVID-19 testing and observe all other infection control requirements, including face coverings.
• Annual Flu vaccination is required as a condition of hire and ongoing employment.
• Only those who are allergic to the vaccine or meet contraindications as indicated on the current CDC Vaccine Information Statement shall be exempt from this condition of hire and ongoing employment but are required to wear a mask while inside an API owned or operated building or vehicle during influenza season, Employees must provide physician documentation to support any reported allergy or contraindication.
• Flu season typically runs between November and March.
• Pass drug and alcohol test performed by Concentra.
• Clear TB skin test or Chest X-Ray at Concentra.
• Complete a satisfactory physical examination at Concentra designed solely to determine your ability to perform the duties of the position being offered.

Nice To Haves

• Experience in psychiatric field preferred.

Responsibilities

• Conducts concurrent and extended stay reviews
• Prepares and submits appeals to 3rd party payers.
• Maintains appropriate records of the Utilization Review Department.
• Participates in activities which enhance professional growth and development.
• Other duties as assigned.

Benefits

• Equal employment opportunities to all employees and applicants for employment and prohibits discrimination and harassment of any type without regard to race, color, religion, age, sex, national origin, disability status, genetics, protected veteran status, sexual orientation, gender identity or expression, or any other characteristic protected by federal, state or local laws.

What This Job Offers

• Job Type: Full-time
• Career Level: Mid Level
• Education Level: Associate degree