Utilization Review Assistant (RN)

JOB DESCRIPTION

At BryLin Hospital our mission and vision are as follows:

MISSION: To be the first choice for healing, wellness and recovery through innovative and individualized care.

VISION: We look to the future in an ever-changing industry for opportunities to grow as a behavioral health system. Through this growth, we will inspire our patients and their families to fully reach their potential.

For over 60 years, BryLin has been providing compassionate mental health care for individuals of all ages. Our individualized care promotes healing, wellness and recovery while respecting the dignity of our patients, their families, and others. Where there’s help, there’s hope.

BryLin is currently hiring for a part time:

Utilization Review Assistant

9:30am-3:30pm

JOB RESPONSIBILITIES:

• Demonstrates a thorough knowledge of BryLin Hospitals established inpatient Behavioral Health Criteria and Utilization Review Plan.
• Maintains compliance with Federal, State and commercial insurance guidelines.
• Applies critical thinking and interprets clinical criteria to determine appropriate level of care and services provided.
• Conducts telephone reviews with providers to determine medical necessity for admission and continued hospitalization.
• Follows relevant time frame standards for conducting reviews, obtaining authorizations and communicating determinations.
• Demonstrates the ability to organize early work assignments and maintain discharge records as per the Utilization Review operational guidelines.
• Demonstrates the ability to maintain proper documentation for standard review activities including:
• authorization notation forms.
• daily productivity logs.
• interoffice notification forms.
• Demonstrates the ability to appropriately process the following:
• authorization for reimbursement.
• requests for peer reviews.
• denials and appeals.
• pre-certification for post discharge services.
• Collaborates and communicates with members of the health care team in matters of:
• nursing care.
• patient progress.
• treatment plan issues
• discharge planning.
• status of denials and appeals.
• Identifies and communicates to the Utilization Review Director all provider, physician and quality concerns and issues.

REQUIREMENTS:

• Minimum one year experience working with psychiatric and chemical dependency patients.
• Utilization Review and case management experience
• Licensure as a Registered Professional Nurse in New York State

This individual will need to demonstrate the ability to apply medical criteria effectively, think critically to solve problems, communicate assertively, work independently while meeting daily and weekly deadlines, provide exceptional customer service, adapt to new challenges with a willingness to learn, and take pride in achieving professional goals.

A person with a fit for our organizational values, someone that understands the importance of mental health services in our community.

Wage is based on education and experience. We do offer a shift differential for the evening and overnight shifts.

Must have the ability to pass pre-employment background checks including a drug screen.

Equal Opportunity Employer

Job Type: Part-time

Pay: $29.78 - $35.17 per hour

Schedule:

• 8 hour shift
• Day shift
• Monday to Friday

Application Question(s):

• How did you hear about BryLin?

Education:

• Associate (Required)

Experience:

• Utilization review: 1 year (Required)
• Clinical Documentation & Utilization Review Nurses: 1 year (Preferred)

License/Certification:

• RN (Required)

Work Location: In person

Salary : $30 - $35