Utilization Rvw Case Manager
Job ID: 420499
Category: Corporate Services
Location: Sarasota, FL
Department: Psych I/P Adult
Facility: Sarasota Memorial Hospital
Performs facility and third party payor admission and concurrent reviews. Facilitates peer review as dictated by the Utilization Review Plan. Attends treatment planning meetings to assist with the documentation of care/treatment. Monitors discharge plan development. Knowledgeable and applies current InterQual criteria (IS, SI).
– Require a minimum of three (3) year of experience working in a behavioral health setting. Must have a minimum of one (1) year of experience obtaining insurance authorizations from third party payors.
– Require current Florida LCSW, LMHC, RN, or LPN license.
– Prefer utilization review experience along with monitoring and evaluating records for quality and appropriateness of care.
– Prefer demonstrated knowledge of regulatory and reimbursement requirements.
– Prefer demonstrated knowledge of chart analysis and data retrieval.
– Prefer demonstrated interpersonal and oral/written communication skills.
– Prefer the ability to form effective working relationships with the various disciplines involved in the treatment and care of psychiatric patients.
– Prefer demonstrated computer literacy with windows-based programs and other applications.