Utilization Assistant PRN

Maple Heights Behavioral Health • Fort Wayne, IN

2d • Onsite

About The Position

Provide administrative support to the Utilization department. This role involves performing pre-certification, negotiating continued stay with third-party payers, gathering data to support case management activities, and coordinating discharge planning. The assistant will also present case information, assist in admissions and concurrent reviews, and support physicians in peer reviews by serving as an information resource. Additionally, the role requires documenting utilization activities, participating in performance improvement, and performing other assigned duties.

Requirements

• High school diploma or equivalent required.

Nice To Haves

• Current certification as Registered Addiction Specialist, certified Substance Use Counselor or similar certification preferred.

Responsibilities

• Perform pre-certification and negotiate continued stay with third party payers.
• Gather data to support case management activities, including presentation of gathered data and case notes.
• Coordinate discharge planning with clinical team, maintain CRM database with discharge information and follow up.
• Present case information and the needs of third-party payers.
• Assist in admissions review, concurrent reviews and discharge planning.
• Assist physician in peer review by serving as information resource, gather data to support review and schedule peer review.
• Informs management about the status of current patients; documents utilization activities as instructed.
• Participates in performance improvement activities.
• Perform other functions and tasks as assigned.

What This Job Offers

• Job Type: Part-time
• Career Level: Entry Level
• Education Level: High school or GED