What are the responsibilities and job description for the Utilization Review Coordinator position at Sierra Health and Wellness?
Sierra Health and Wellness use evidence-based methods to accomplish the restoration of families, relationships, and self-worth. By transforming the character, we give life back to the people who have lost it through substance abuse and mental health issues.
Position Open:
The role of the Utilization Review Coordinator is to implement the organization’s Utilization Review (UR) process to ensure appropriate usage of available resources and to optimize reimbursement for services rendered in accordance with patient need. Ensure UR function is performed in compliance with the P&P, certification standards, and State/Federal statutes and/or regulations.
Essential Functions:
Reasonable accommodation may be made to enable individuals with disabilities to perform these essential functions.
Required education and experience:
Sierra Health and Wellness are a California network of leading behavioral health and rehab centers for adults and families who suffer from addiction to alcohol, opiates, amphetamines and other addictive substances.
Sierra Health and Wellness is an Equal Opportunity Employer that does not discriminate against applicants, employees or clients on the basis of race, color, religion, sex, sexual orientation, gender identity, national origin, age, marital status, genetic information, disability, veteran status or any other category protected by the law, or patients' decisions regarding advance directives. Not all services are available at all offices.
https://www.sierrahealthwellnesscenters.com/
Salary: $68,000- $90,000
The posted pay range is a reasonable estimate that the organization believes in good faith it may pay for this particular job based on the circumstances at the time of posting. This pay range is not a promise of a particular wage. Pay may consider several factors including but not limited to internal equity, experience, specialty, training, hours/shifts worked, business need, and education. Pay ranges may be adjusted in the future depending upon many factors including business needs.
Position Open:
- Full-time -Remote
- Competitive pay
- 10 days paid vacation
- 10 holidays/ 5 sick days per year
- Medical, Dental, and Vision benefits with NO monthly premium for employee (eligible after 60 days of employment)
- 401K with a company match of up to 3%n (eligible after 1 year of employment)
- Employer-paid accident & life Insurance (eligible after 60 days of employment)
The role of the Utilization Review Coordinator is to implement the organization’s Utilization Review (UR) process to ensure appropriate usage of available resources and to optimize reimbursement for services rendered in accordance with patient need. Ensure UR function is performed in compliance with the P&P, certification standards, and State/Federal statutes and/or regulations.
Essential Functions:
Reasonable accommodation may be made to enable individuals with disabilities to perform these essential functions.
- Monitors the client population daily and regularly checks documentation for compliance with current UR best practices.
- Gather information and contact insurance case managers with accurate reports on clients’ medical information and the level of engagement in treatment.
- Maintain an accurate account of the level of care granted by the insurance companies.
- Maintain daily information on the client that is accurate and held to strict confidentiality and HIPAA regulations.
- Participate in staffing meetings.
- Conduct peer reviews as well as pre-certifications and concurrent reviews.
- Conduct staff training.
- Audit EHR documentation as well as document all client-related activities in the EHR.
- Performs other duties and tasks as assigned.
Required education and experience:
- High School Diploma or GED.
- One year of experience working with adults struggling with substance abuse.
- Valid Driver’s License
- Three years experience working as a Utilization Review Coordinator or similar role.
Sierra Health and Wellness are a California network of leading behavioral health and rehab centers for adults and families who suffer from addiction to alcohol, opiates, amphetamines and other addictive substances.
Sierra Health and Wellness is an Equal Opportunity Employer that does not discriminate against applicants, employees or clients on the basis of race, color, religion, sex, sexual orientation, gender identity, national origin, age, marital status, genetic information, disability, veteran status or any other category protected by the law, or patients' decisions regarding advance directives. Not all services are available at all offices.
https://www.sierrahealthwellnesscenters.com/
Salary: $68,000- $90,000
The posted pay range is a reasonable estimate that the organization believes in good faith it may pay for this particular job based on the circumstances at the time of posting. This pay range is not a promise of a particular wage. Pay may consider several factors including but not limited to internal equity, experience, specialty, training, hours/shifts worked, business need, and education. Pay ranges may be adjusted in the future depending upon many factors including business needs.
Salary : $68,000 - $90,000
