Utilization Review Specialist Job at Reno Behavioral Healthcare Hospital, Reno, NV

S3R2UGtqa1BYMk11OG5SZmtnTDVya2lx
  • Reno Behavioral Healthcare Hospital
  • Reno, NV

Job Description

The UR Specialist reviews and monitors patients’ utilization of health care services with the goal of maintaining high quality, cost-effective care. The duties include providing the medical and utilization expertise necessary to evaluate the appropriateness and efficiency of medical services and procedures.

  • Performs concurrent and retrospective reviews on all patients. Monitors level and quality of care.
  • Responsible for the proactive management of patients with the objective of improving quality outcomes and decreasing costs.
  • Evaluates and provides feedback to treating physicians regarding a patient’s discharge plans and available covered services, including identifying alternative levels of care that may be covered.
  • Monitors all utilization reports to assure compliance with reporting and turnaround times.
  • Addresses care issues with the Director of Clinical Services and Chief Medical Officer/Medical Director as appropriate.
  • Coordinates an interdisciplinary approach to support continuity of care.
  • Provides utilization management, transfer coordnation, discharge planning, and issuance of all appropriate authorization for covered services as needed.
  • Identifies and recommends opportunities for cost savings and improving the quality of care across the continuum.
  • Clarifies health plan medical benefits, policies and procedures for members, physicians, staff, contract providers, and outside agencies.

Requirements

  • Bachelor's degree in Social Work or related field required.
  • Clinical Licensure in the State of Nevada preferred.
  • Knowledge of medical terminology, medical records, and appropriate medical coding system.
  • Working knowledge with software and/or equipment (Microsoft Office applications including Outlook, Word, Excel and PowerPoint).
  • Maintains confidentiality of patients at all times.

Benefits

We proudly offer the following benefits available first of the month following just one month of employment:

  • Competitive rates
  • Flexible schedules
  • Tuition reimbursement
  • Comprehensive package of benefits to include:
    • Medical
    • Dental
    • Vision
  • Life, Pet, Identity Theft Insurance
  • 401k
  • Generous paid time off
  • Short Term and Long Term Disability

Job Tags

Full time, Contract work, Temporary work, Flexible hours,

Similar Jobs

Mississippi College

Instructor/Assistant Professor of Nursing - School of Nursing (2 positions) Job at Mississippi College

Instructor/Assistant Professor of Nursing - School of Nursing (2 positions)Mississippi College...  ...Professor of Nursing. This full-time faculty position is a critical part of our...  ...Familiarity with simulation-based instruction and online learning platforms;Experience with... 

Hire Our Heroes Veteran Job Board

Salesforce Administrator Job at Hire Our Heroes Veteran Job Board

Python ML Engineer sought by Health Data Vision, Inc. dba Reveleer in Glendale, CA. Bachelor's or equiv plus 1 yr exp. in related field. Telecommuting Permissible. $95,400/yr. Send resume to: Mediha Odzakovic, Talent Acquisition Manager, Health Data Vision, Inc. dba Reveleer...

Worksite PAY

Entry Level Sales Rep - Orange County Job at Worksite PAY

Worksite PAY is hiring an Account Executive - Sales Rep. In this position, you'll identify and cultivate new prospects from relationships built with Bankers, Accountants, existing clients, as well as direct prospecting efforts. In addition you will cross-sell solutions...

ABM Industries

Parking Attendant and Maintenance Job at ABM Industries

 ...Parking Attendant must be flexible and willing to complete all tasks that are assigned. The Parking Attendant will be entrusted with cash and credit payments and be required to account for all vehicles and their payments for the day.Schedule: Full time Monday through... 

Chadwell Supply

Delivery Manager (Logistics) Job at Chadwell Supply

 ...Top Companies USA 2022, 2023, and 2024! Overview The Branch Delivery Logistics Manager oversees the transporting of products, goods...  ...coordinate to perform and complete all deliveries, vendor pick-ups and other delivery driver duties as assigned by Management. Monitor...