UR Case Manager
About The Position
Alvarado Parkway Institute (API), a freestanding psychiatric hospital in La Mesa, California, provides adult inpatient behavioral health and addictive disorders services in a 66-bed hospital, along with Intensive Outpatient and Partial Hospitalization programs. API is seeking a UR Case Manager to monitor and ensure appropriate allocation of hospital resources. The Utilization Review / Case Management Department addresses appropriate, excessive, insufficient, and inefficient use of resources. The role requires knowledge of psychiatric symptoms, behaviors, and diagnoses and works closely with the treatment team to ensure documentation meets regulatory requirements. Strong communication and organizational skills are required, as is the ability to multitask and function well under stress. Applicants must complete an online application on API’s website to be considered. Employment conditions include satisfactory background and reference checks, signing an employment non-compete/confidentiality agreement, and maintaining any required license, registration, or certification. Employees must also meet API’s flu vaccination requirement or applicable exemption conditions, pass a drug and alcohol test, receive a clear TB skin test or chest X-ray, and complete a satisfactory physical examination designed to assess ability to perform the position’s duties. API provides equal employment opportunities and prohibits discrimination and harassment.
Requirements
- High-school-level, preferably college-level, reading, writing, and math skills.
- Excellent telephone usage and strong verbal communication skills.
- Knowledge of health care service delivery systems and third-party reimbursement.
- Understanding of admission and discharge functions.
- 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 and familiarity with applicable standards and regulations.
- Ability to comprehend psychiatric evaluations, consults, laboratory results, and similar information.
- Flexibility, attention to detail, and responsiveness to deadlines.
- Assertiveness, persistence, and persuasiveness.
- Ability to work with minimal direction or supervision.
- Graduate of an accredited RN/LVN program with a current RN/LVN license, or master’s-level training in a behavioral health field.
- Satisfactory background and reference checks.
- Maintain a current and valid license, registration, or certification if required for the position.
- Meet API’s annual flu vaccination requirement or applicable exemption conditions.
- Pass a drug and alcohol test and receive a clear TB skin test or chest X-ray.
- Complete a satisfactory physical examination to determine ability to perform the position’s duties.
- Employee must sign an employment non-compete/confidentiality agreement.
Nice To Haves
- Experience in the psychiatric field.
Responsibilities
- Conduct concurrent and extended-stay reviews.
- Prepare and submit appeals to third-party payers.
- Maintain appropriate records of the Utilization Review Department.
- Participate in activities that enhance professional growth and development.
- Perform other duties as assigned.
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What This Job Offers
Job Type
Full-time
