Job Description

Job Description

Responsibilities

The Sierra Vista Hospital location, a 171-bed psychiatric care facility located in south Sacramento, is a full-service mental health facility and a center of support for patients and their families. Since 1986, we have offered our clinical expertise to those suffering from emotional, behavioral and addiction problems.

POSITION SUMMARY

The utilization Review clinician is responsible to manage pre certification and continued authorization for all patients admitted to a SVH program to maximize profitability and minimize any financial loss to the hospital and the patient. Using an ongoing, systematic process for continued authorizations on every current admission per the payor guidelines and contract.

The Utilization Review Clinician (URC) will review the patient's medical record on specific days to meet continued authorization. Certification of medical necessity is required, including regulatory and corporate audits as indicated. Provide written appeal letters for all of the assigned CM denials.

Qualifications

QUALIFICATIONS

Education: Master's degree required from an accredited college or university in social work, mental health or a related field or equivalent for licensure.

Experience: A minimum of one (1) year experience with communication with external review organizations or comparable entities and direct clinical experience in a psychiatric or mental health setting is preferred.

Licensure: R.N., MSW, MFT, licensed preferred

Additional Requirements: Completion of CPR with-in first 30 days and moderate knowledge of Microsoft office applications such as excel and word, with the ability to learn and master internal automated systems and processes.

EEO Statement

All UHS subsidiaries are committed to providing an environment of mutual respect where equal employment opportunities are available to all applicants and teammates. UHS subsidiaries are equal opportunity employers and as such, openly support and fully commit to recruitment, selection, placement, promotion and compensation of individuals without regard to race, color, religion, age, sex (including pregnancy, gender identity, and sexual orientation), genetic information, national origin, disability status, protected veteran status or any other characteristic protected by federal, state or local laws. We believe that diversity and inclusion among our teammates is critical to our success.

Notice

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