Utilization Review Specialist

Employment Type

: Full-Time

Industry

: Miscellaneous



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Overview

Rainier Springs is a 72-bed behavioral hospital located near Vancouver, WA. The hospital offers inpatient and outpatient mental health and addiction treatment to adults, adolescents and their families. At Rainier Springs we are dedicated to Changing People’s Lives® .

The Utilization Review department plays an essential role in helping fulfill our mission of “ Changing People’s Lives®”. Utilization Review team members advocate on behalf of our patients to managed care providers for necessary treatment. As a Utilization Review Specialist, you will accurately and timely complete utilization review activities.

Members of our team Enjoy:

  • Working with a highly engaged staff
  • Healthy staffing levels
  • Flexible scheduling
  • Career growth
  • Competitive compensation
  • Position Details

  • Actively Communicate with interdisciplinary team members to acquire information and give updates on authorizations
  • Ensure all pre-certifications are completed for inpatient and outpatient services.
  • Monitor hospital LOS, report appropriately.
  • Work with Director of Nursing to ensure documentation requirements are met
  • Interface with managed care organizations, external reviews, and other payers.
  • Qualifications

    Requirements:

  • Bachelor’s Degree
  • Current unencumbered clinical licensure and valid driver’s license
  • CPR and CPI Certification within 30 day of employment
  • Experience:

  • Previous utilization review experience in a psychiatric healthcare facility preferred

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