What are the responsibilities and job description for the UTILIZATION REVIEW SPECIALIST position at The Pavilion Behavioral Health System?
Responsibilities
JOB SUMMARY:
Responsible to ensure that open charts are reviewed appropriately to identify the utilization of services. The information collected by the Utilization Review Specialist will be used to contact insurance/review companies to obtain certification for the hospital stay.
Qualifications
JOB SPECIFICATIONS:
To perform this job successfully, an individual must be able to demonstrate competency in the criteria listed in this job description. The specifications listed below are representativ9260e of the knowledge, skill, and ability to meet the minimum requirements for this position. Staff must demonstrate flexibility for reassignments to units.
Education: Masters Degree in Social Work, Counseling, Psychology, or Education.
L.P.C or L.C.S. W required. L.P.C.’s should be working toward L.C.P.C. status.
Experience: Two years mental health and/or related experience. Knowledge of hospital operations, nursing operations, and insurance review contacts preferred. Possesses the ability to maximize effective communication and working relationships through all mediums, especially the telephone. Minimum of two years of experience in mental health, chemical dependency, education and group facilitation preferred. Basic knowledge related to personal computer utilization.
Physical Demands: Ability to communicate verbally and in writing. Push, pull and lift up to 20 pounds. Intermittent sitting, standing and walking. Ability to work on data entry. Drug and alcohol free as evidenced by negative result of post-offer, pre-employment urine drug screen.
