UHS
Location
Sacramento, California
The Utilization Review Clinician manages, reviews, and monitors resource utilization for patients to maximize care effectiveness by evaluating clinical appropriateness. This role acts as a liaison between payors, the business office, and the treatment team to ensure optimal patient care and reimbursement, including securing authorizations for services.
Candidates must possess a Master’s degree in social work, mental health, or a related field, along with either one year of experience communicating with external review organizations or four years of direct clinical experience in a psychiatric setting. Prior experience with prior authorizations or Case Management is mandatory.
Master’s degree in social work, mental health or a related field.
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. Prior experience with prior authorizations or Case Management is preferred.