Utilization Management Clinician

Utilization Management Clinician

Universal Health Services | Sacramento, CA, 94204, US
Salary Range:$62,000 – $88,000 Salary range estimated by Zippia

Posted a month ago

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Description

Responsibilities

Sierra Vista Hospital is seeking Utilization Management Clinicians for the Utilization Management Department. If you're passionate about working in the behavioral health setting and have the desire to join a team of healthcare professionals dedicated to serving our patients, we want to hear from you!

Universal Health Services, Inc. (UHS) is one of the nation's largest and most respected healthcare management companies, operating through its subsidiaries acute care hospitals, behavioral health facilities and ambulatory centers nationwide. Founded in 1978, UHS subsidiaries now have more than 65,000 employees. The UHS business strategy is to build or purchase health care properties in rapidly growing markets and create a strong franchise based on exceptional service and effective cost control. Our success comes from a responsive management style and a service philosophy based on integrity, competence and compassion.

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 management 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 Management Clinician (UMC) 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.