What are the responsibilities and job description for the Outpatient UR Clinician (RN, MFT, MSW, LMFT, AMFT, LCSW, ASW) position at UHS?
Heritage Oaks Hospital is part of the UHS Family of Providers which has been highly regarded as an integral part of the greater Sacramento and Northern California mental health system since 1988. Conveniently located in northern Sacramento, Heritage Oaks is a fully accredited, 125-bed acute psychiatric hospital offering a full range of individually tailored treatment services to adolescents, adults, and senior adults, including treatment for substance abuse and chemical dependency issues with drugs and alcohol. Heritage Oaks is a Medicare provider in addition to contracts with most commercial health insurance plans. We are committed to providing service excellence to all and ensuring our patients receive the optimal level of care that will be most beneficial to their health and recovery.
Website: https://heritageoakshospital.com/
The Utilization Review Clinician is responsible for managing, reviewing and monitoring the utilization of resources related to the patient and to maximize effectiveness of care by evaluating clinical appropriateness. The Utilization Review Clinician functions as liaison between payors, the business office, and treatment team, providing information and feedback to assist in optimum patient care and reimbursement. The UR Clinician will also review with payor sources and receive authorization for the type and volume of services through all levels of care and aftercare review.
- Works cooperatively with Assessment & Referral in establishing clinical pre-authorization
- Communicates with the business office regarding any information pertaining to insurance benefits and coverage.
- Attend treatment planning meetings and oversee the coordination of care for patients in respect to the available financial resources which includes notifying attending physician/treatment team of actual or potential denial.
Heritage Oaks offers comprehensive benefits such as:
- Competitive Compensation
- Excellent Medical, Dental, Vision, and Prescription Drug Plan
- Generous Paid Time Off
- 401(K) with company match and discounted stock plan
- Career development opportunities within UHS and its Subsidiaries
- Education Assistance
- Challenging and rewarding work environment
Qualifications
Education:
RN: Prefer bachelor’s degree from an accredited college or university in nursing.
ASW, MFT, MSW, etc: Master's degree in social work, mental health or a related field required.
Experience: A minimum of one (1) year experience with communication with external review organizations or comparable entities or four (4) years direct clinical experience in a psychiatric or mental health setting.
Licensure: RN, LCSW, MFT, MSW, ASW or applicable license.
Additional Requirements: CPR certification required.
About Universal Health Services
One of the nation’s largest and most respected providers of hospital and healthcare services, Universal Health Services, Inc. (UHS) has built an impressive record of achievement and performance. Growing steadily since its inception into an esteemed Fortune 500 corporation, annual revenues were $14.3 billion in 2023. During the year, UHS was again recognized as one of the World’s Most Admired Companies by Fortune; and listed in Forbes ranking of America’s Largest Public Companies. Headquartered in King of Prussia, PA, UHS has approximately 96,700 employees and continues to grow through its subsidiaries. Operating acute care hospitals, behavioral health facilities, outpatient facilities and ambulatory care access points, an insurance offering, a physician network and various related services located all over the U.S. States, Washington, D.C., Puerto Rico and the United Kingdom. www.uhs.com
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.
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Salary : $14
