UR Case Manager

Alvarado Parkway Institute • La Mesa, CA

1d • 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. Alvarado Parkway Institute (API) provides comprehensive adult inpatient behavioral health and addictive disorders services in a 66-bed hospital setting located in La Mesa, California. At Alvarado Parkway Institute, we are committed to improving the mental health and well-being of our community. Alvarado Parkway Institute in La Mesa 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. API provides 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.

Alvarado Parkway Institute 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.

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

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.

What This Job Offers

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