Utilization Management Analyst

Virginia Information Technologies Agency•Fairfax County, Virginia, VA

1d•$70,700•Onsite

About The Position

The Utilization Management Analyst will be responsible for submitting authorization and certification reviews for insured admissions with Managed Care Organization or third-party payers. This will include conducting chart reviews and continued stay reviews in accordance with set intervals, consulting with treatment teams to guide certification decisions, and maintaining communication with internal and external partners to ensure maximum collection of reimbursement for services.

Requirements

Demonstrated knowledge of inpatient psychiatric treatment and documentation required, to include interdisciplinary treatment planning, discharge planning, and psychosocial rehabilitation.
Ability to communicate effectively, both orally and in writing, with clinicians, administrators, and patients.
Knowledge of utilization management principles, third-party reimbursement systems, and associated legal/regulatory requirements.
Basic computer proficiency required with typing skills, Microsoft Word, Microsoft Excel, AVATAR, EHR.
Ability to produce and present computer-generated reports with narrative and graphic data analysis.
Ability to write policies, procedures, and instructional tools; design forms; produce memorandums and meeting minutes.
Ability to work independently to include organization, prioritization, and maintaining timeliness of multiple tasks/projects.
Teaching and presentation skills.

Responsibilities

Submitting authorization and certification reviews for insured admissions with Managed Care Organization or third-party payers.
Conducting chart reviews and continued stay reviews in accordance with set intervals.
Consulting with treatment teams to guide certification decisions.
Maintaining communication with internal and external partners to ensure maximum collection of reimbursement for services.