Utilization Review Case Manager

UHS•Olive Branch, MS

1d•Onsite

About The Position

Parkwood Behavioral Health System provides behavioral health and chemical dependency services to the Mid-South region. We offer a full continuum of care that provides treatment options to meet the individual needs of adults, adolescents and children. Parkwood Behavioral Health System includes a 148-bed inpatient acute and residential care facility, as well as partial hospitalization and intensive outpatient programs. The Case Manager provides utilization review services in a manner consistent with the philosophy and objectives of the facility. The Case Manager evaluates patient medical records to determine severity of patient’s illness and determines the appropriateness of level of care. Serves as liaison for patients and hospital with insurance companies. Negotiates and advocates for patient length of stay and level of care. Oversees utilization review activities with other departments to ensure reimbursement for services provided by the hospital.

Requirements

Bachelor degree in Nursing or human services field preferred
Minimum of 2 years clinical experience
1 year of management experience with case management and the utilization review process including concurrent reviews.
LPN or RN preferred
Prefer knowledge of case management, discharge planning, age specific growth and development, crisis and behavior management.

Nice To Haves

Previous continuum of care experience highly preferred.

Responsibilities

Evaluates patient medical records to determine severity of patient’s illness and determines the appropriateness of level of care.
Serves as liaison for patients and hospital with insurance companies.
Negotiates and advocates for patient length of stay and level of care.
Oversees utilization review activities with other departments to ensure reimbursement for services provided by the hospital.