Utilization Review Manager - Home Care jobs in Alabama

Bradford Health Services, a leader in the substance abuse addiction and recovery industry is looking for a Utilization Review Specialist for its Tuscaloosa, AL location.

As the UR Specialist, you will work with medical professionals, payors, and healthcare providers to ensure each patient has access to the appropriate level of care and length of stay to provide them the best chance at recovery.

The preferred candidate will hold a Bachelor's degree or current ALC, LPC, LMFT, LMSW or LCSW license. Two years of experience in utilization review and the ability to comprehend medical information and policy is preferred.

Along with excellent verbal and written communication skills, each candidate should possess strong computer skills to accurately document patient health information and supporting treatment notes.

General responsibilities include :

• Perform all pre-admission certification reviews, continued stay reviews, appeals, denials, and / or reconsiderations and provide information to the appropriate review agency or insurance company.
• Maintain accurate patient notes and complete appropriate documentation to the patient’s electronic health record.
• Provide follow-up and support calls to providers and insurance carriers as needed.
• Review and maintain all correspondence pertaining to certification, appeals, denials or reconsiderations.
• Educate counseling staff regarding data needed to adequately document patient care and educate crisis staff regarding data needed to adequately document intake assessments and managed care criteria.
• Work collaboratively with co-workers, managers, clients, and prospective clients.
• Complete other duties as assigned by the supervisor.

We provide :

• Competitive pay

Last updated : 2024-06-11