Utilization Review Nurse (RN)
About The Position
Lighthouse Care Center of Augusta is seeking a dedicated, compassionate Utilization Review Nurse to add to our growing team. Lighthouse Care Center of Augusta (LCCA) is a multi-discipline behavioral healthcare center that offers mental health services to the communities of surrounding Augusta, Georgia. The Lighthouse Care Center of Augusta is an acute and residential treatment facility providing balanced, top-notch clinical care to children, adolescents and young adults. We provide a carefully-structured and supportive environment, and our education program is accredited through the Georgia Accrediting Commission. This role operates under the direction of the Director of Utilization Management.
Requirements
- Registered Nurse (RN) preferred or License Professional Nurse (LPN)
- Current GA or Multistate Valid RN or LPN license
- Must have 2 years of experience in a psychiatric health care setting, delivery of care to psychiatric and/or chemically dependent patients and utilization review
Responsibilities
- Review clinical content of medical records
- Participate in treatment team meetings
- Collaborate with physicians, therapist, nurses and pertinent staff on gathering the necessary data to communicate with insurance companies/authorizing entities to ensure initial precertification and continued authorization is achieved
- Ensure input of pre-certifications and continued stay reviews into Midas
- Follow-up on unfinished pre-certifications from the day before
- Coordinate with the treatment team on any follow-ups necessary
- Verify insurance coverage at the first of the month, and post patient payments into MS4
- Trained in all aspects relative to timely gathering clinical criteria, communication of clinical criteria, and entry of supporting clinical criteria into computer based systems
Benefits
- Referral Bonus Program
- Challenging and rewarding work environment
- Competitive Compensation & Generous Paid Time Off
- Excellent Medical, Dental, Vision and Prescription Drug Plans
- 401(K) with company match and discounted stock plan
- Career development opportunities within UHS and its 300+ Subsidiaries!
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What This Job Offers
Job Type
Full-time
Career Level
Mid Level
Education Level
No Education Listed
