Job detail

Utilization Review Specialist LVN

Bakersfield Behavioral Healthcare Hospital

#Mental Health #Managed Care #Insurance Authorization #LVN #Detoxification #Utilization Review #Psychiatric Care #Behavioral Healthcare #Medical Necessity

Quick overview

The specialist reviews medical records to prepare clinical appeals and manage authorizations and denials for patients. They coordinate with external case managers and insurance organizations to ensure certification of benefits and guide the treatment team on requirements.

Requirements summary

Candidates must possess a current and unencumbered California LVN license and a high school diploma. Experience in utilization review within a behavioral or psychiatric healthcare setting is preferred.

high schoolassociate degreeTeamworkCase ManagementCommunicationLeadershipCritical ThinkingDischarge PlanningUtilization ReviewMedical Record ReviewClinical AppealsInsurance Certification

Job description

About Us Bakersfield Behavioral Healthcare Hospital, located in Bakersfield, California, is an acute psychiatric and behavioral 90 bed facility situated on 8.8 acres.
We offer inpatient and outpatient services for children, adolescents and adults needing mental/behavioral health, chemical dependency; and co-occurring disorders treatment through our medically supervised detoxification.
Within our Workplace Community, BBHH is striving daily to be one of the BEST PLACES TO WORK not just here in Kern County, but throughout the Behavioral Healthcare Community.
By offering amazing benefits, encouraging individual growth and development, and incorporating our CARES values system into our daily operations, we are creating a workplace culture where people enjoy coming to work each day.
BBHH CARES about your experience as a candidate and we encourage you to apply to our open positions.
Compassion Acceptance Respect Empowerment Sincerity Our progressive and dedicated healthcare team strives to change the lives of our patients and provide exceptional care.
This is a fast-paced environment that requires critical thinking, exceptional leadership, teamwork, and communication skills.
ESSENTIAL DUTIES The primary responsibility of the Utilization Review Specialist is to review medical records and prepare clinical appeals (when appropriate) on medical necessity, level of care, length of stay, authorizations and denials for patients.
The UR Specialist is responsible for contacting external case managers/managed care organizations for certification and recertification of insurance benefits throughout the patient’s stay, and assists the treatment team in understanding the insurance company’s requirements for continued stay and discharge planning.
The UR Specialist is responsible for having a thorough understanding of the patient’s treatment through communication with the treatment team.
The UR Specialist advocates for the patient’s access to services during treatment team meetings and through individual physician contact.
The UR Specialist chairs treatment team meetings and continued stay reviews as indicated. wage range: $27.07/hr. - $33.37/hr. based on experience WHAT WE'RE LOOKING FOR Simply put: HUMANS WHO CARE Though we do need to meet some minimum requirements for the position such as a High School Diploma and a current and unencumbered California LVN License, we're really looking for people who bring their HEART to work.
If you have previous experience in a mental healthcare hospital environment where your attention was focused on human behavior, psychiatry, psychology, or other mental healthcare situations, your application to this position will be moved to the shortlist of candidates.
Education Associate Degree preferred Minimum Work Experience Utilization Review experience preferably in a behavioral/psychiatric healthcare setting or similar type of organization preferred.
Required Licenses Current Unencumbered California LVN license Bakersfield Behavioral Healthcare Hospital is proud to offer a suite of benefits to those who join our workplace community. *Benefits eligibility varies based on employment status (full-time, part-time, per diem, temporary, etc.).
Some of the benefits you can expect as a Full-Time employee include: Paid Time Off over THREE WEEKS of Paid Time Off in your first year!!!
Life Insurance Short-Term Disability Insurance Long-Term Disability Insurance Medical Insurance Dental Insurance Vision Insurance Pet Insurance Accident Insurance 401k Retirement Plan Discounted Meals Employee Assistance Program TUITION REIMBURSEMENT

Utilization Review Specialist LVN

Quick overview

Requirements summary

Job description

Benefits

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