UTILIZATION OUTCOMES SPECIALIST

UHS • Oakland Park, FL

10d

About The Position

Fort Lauderdale Behavioral Health Center, a subsidiary of UHS, is a 180-bed private hospital specializing in treatment for drug addiction, mental health issues, and concurrent disorders in adults and adolescents. The Utilization Outcomes Specialist coordinates and monitors appropriate utilization and documentation of services during inpatient and outpatient treatment and coordinates authorizations with third-party payors. The role reviews cases for appropriateness of admission, continued stay, and discharge planning, and supports high-quality patient care through analysis, review, and evaluation of clinical practices. It also recommends corrective action plans, monitors their impact, maintains treatment-related communication through documentation and verbal exchange, and communicates with internal and external entities to facilitate access to resources.

Requirements

• Master’s degree, or RN licensure, from an accredited college or university in social work, mental health, or a related field.
• Crisis Prevention Intervention (CPI) certification or equivalent required.
• CPR.
• At least two years of direct clinical experience in a psychiatric or mental health setting.
• Experience in patient assessment, family motivation, and communication with an external review organization or comparable entities.
• Skills in applying DSM methodology.
• Excellent telephone etiquette, tact, audible speech, and enunciation.
• Ability to interact effectively with people in diverse roles, backgrounds, cultures, and socioeconomic classes.
• Effective oral and written communication skills and ability to analyze and evaluate information.
• Ability to concentrate on tasks and meet deadlines.
• Intermediate computer skills.
• Organizational, time-management, problem-solving, crisis-management, flexibility, creativity, and stress-management skills.
• Understanding of appropriate clinical assessment, diagnoses, and interventions with patients.
• Understanding of admission and discharge criteria and functions.
• Understanding of medical terminology, diagnostic terms, treatment modalities, and medical record keeping.
• Understanding of psychiatric evaluations, medical consultations, lab results, medication management, and other components of patient treatment.
• Cultural sensitivity and awareness of diverse cultures and practices.

Responsibilities

• Coordinate and monitor appropriate utilization and documentation of services throughout treatment for inpatient and outpatient patients.
• Coordinate authorizations with third-party payors.
• Review cases for appropriateness of admission, continued stay, and discharge planning.
• Support high-quality patient care by analyzing, reviewing, and evaluating clinical practices within the Behavioral Health Center.
• Recommend corrective action plans and monitor the impact of actions taken.
• Maintain communication about treatment through documentation and verbal exchange.
• Communicate with internal and external entities to facilitate acquisition of resources.

What This Job Offers

• Job Type: Full-time