Utilization Review Specialist
Requisition #: 76808
Status: Contingent
Business Unit: Behavioral Services
Shift: Rotating
Department: ADMINISTRATION
Weekends: Yes
Job Family: Quality/Utilization Review
Job Function: Admin Support (Non-clinical)
Campus/Job Location Maple Grove Treatment Center
Location (State/City): US-MI-West Bloomfield
Responsibilities
Under limited direction and in accordance with established policies, procedures, guidelines and criteria, regularly exercises clinical judgment in the review and assessment of patients' records. Reviews care and treatment received. Communicates with third party payers in order to obtain authorization for care. Acts as a resource to related parties by providing training and educational sessions.
Qualifications
EDUCATION AND EXPERIENCE:
- Associate's Degree in Nursing (ADN), Licensed Practical Nurse (LPN), Bachelor's Degree in Social Work, or Registered Health Information Technician (RHIT).
- Also acceptable, in addition to above, Associate or Bachelor's in a related field (i.e., Psychology) with required behavioral health experience.
- Bachelors Degree in Mental Health with two years of experience in mental health preferred.
- Registration Health Information Administrator (RHIA), preferred.
- Minimum of five years of progressively more responsibility. ADDENDUM Henry Ford Macomb-Behavioral Health departments: Experience: 2-5 years behavioral health specific.
- An understanding of addiction care preferred.
WORKING CONDITIONS:
- Works in a normal patient care environment with little exposure to noise, dust, temperature and the like.
- Occasional exposure to communicable diseases and infection when working with patients.
Equal Employment Opportunity / Affirmative Action Employer
Henry Ford Health System is committed to the hiring, advancement and fair treatment of all individuals without regard to race, color, national origin, sex, sexual orientation, age, disability, religion, weight/height, marital status, familial status, veteran status or any other characteristic protected by law.
Requisition #: 76808
Status: Contingent
Business Unit: Behavioral Services
Shift: Rotating
Department: ADMINISTRATION
Weekends: Yes
Job Family: Quality/Utilization Review
Job Function: Admin Support (Non-clinical)
Campus/Job Location Maple Grove Treatment Center
Location (State/City): US-MI-West Bloomfield
Responsibilities
Under limited direction and in accordance with established policies, procedures, guidelines and criteria, regularly exercises clinical judgment in the review and assessment of patients' records. Reviews care and treatment received. Communicates with third party payers in order to obtain authorization for care. Acts as a resource to related parties by providing training and educational sessions.
Qualifications
EDUCATION AND EXPERIENCE:
- Associate's Degree in Nursing (ADN), Licensed Practical Nurse (LPN), Bachelor's Degree in Social Work, or Registered Health Information Technician (RHIT).
- Also acceptable, in addition to above, Associate or Bachelor's in a related field (i.e., Psychology) with required behavioral health experience.
- Bachelors Degree in Mental Health with two years of experience in mental health preferred.
- Registration Health Information Administrator (RHIA), preferred.
- Minimum of five years of progressively more responsibility. ADDENDUM Henry Ford Macomb-Behavioral Health departments: Experience: 2-5 years behavioral health specific.
- An understanding of addiction care preferred.
WORKING CONDITIONS:
- Works in a normal patient care environment with little exposure to noise, dust, temperature and the like.
- Occasional exposure to communicable diseases and infection when working with patients.
Equal Employment Opportunity / Affirmative Action Employer
Henry Ford Health System is committed to the hiring, advancement and fair treatment of all individuals without regard to race, color, national origin, sex, sexual orientation, age, disability, religion, weight/height, marital status, familial status, veteran status or any other characteristic protected by law.