Utilization Review Director in Norcross, GA at Acadia Healthcare

Date Posted: 8/11/2018

Job Snapshot

  • Employee Type:
    Full-Time
  • Location:
    Norcross, GA
  • Experience:
    At least 3 year(s)
  • Date Posted:
    8/11/2018

Job Description

Overview

                                                                                                                                                                 

  Utilization Review Director

At Riverwoods Behavioral Health, we are proud of the reputation we have established by working endlessly to provide excellent care within an environment that fosters long-term healing.

Our determined team of professionals has committed themselves to positively changing the lives of the adolescents, adults, and geriatric patients we serve by supplying caring, compassionate, and skills-based care that is individualized to meet the needs of each person who engages in our programming.

Responsibilities
  • Participates in pre-certifications for admissions with third party payers.
  • Conduct admission review activities.
  • Conducts continued stay review activities.
  • Coordinates third party physician peer-to-peer reviews.
  • Conducts discharge review activities.
  • Notifies third party payers of discharge.
  • Maintains accurate UR information and retrieves date for reports.
  • Communicates results of third party reviews to appropriate staff for length of stay coordination and discharge planning.
  • Establishes and maintains rapport with physicians to ensure adequate, accurate documentation of patient’s care.
  • Establishes and maintains rapport with clinical staff to ensure adequate, accurate, documentation of patient’s care.
  • Participate in treatment plan reviews.
  • Performs concurrent and/or retrospective review/analysis for the appropriateness, effectiveness and efficiency of services.
  • Acts as a resource to other staff on UR/third party requirements.

Job Requirements

  • Bachelor’s degree in Nursing or other clinical degree.
  • At least 3 years’ experience in Utilization Management/Review or Case Management.
  • CPR, CPI, and First Aid required.
  • Excellent interpersonal and writing skills.