7 Utilization Review Specialist Jobs in Tucson, AZ
Amity Foundation is Hiring an Utilization Review Specialist Near Tucson, AZ
About AmityAmity Foundation is a safe place where people can change in an environment that fosters trust; where new values can be formed; responsibility developed, and lasting relationships built. Amity is dedicated to the inclusion and habilitation of people marginalized by addiction, homelessness, trauma, criminality, incarceration, poverty, racism, sexism, and violence. Amity is committed to research, development implementation, and dissemination of information regarding community building
Remembrance, Resolution, Reconciliation, Restoration, Renewal
About The PositionUtilization Review Specialist you will contribute to the organization by providing vital support to the community by developing and/or maintaining effective and efficient processes for determining the appropriate admission status based on the regulatory and reimbursement requirements of various commercial and government payers. This individual is responsible for performing a variety of concurrent and retrospective utilization management-related reviews and functions and for ensuring that appropriate data is tracked, evaluated, and reported.
What You Will Do:
- Collaborates with Admissions to ensure the compliance of new enrollment authorization of clients ("students") into the program
- Working with the enrollment department on ensuring that all new enrollments have the correct paperwork needed for authorization.
- Upload and track paperwork of corresponding AHCCCS approvals and/ or requests for more information
- Conducting and Completing Level of Care interviews for new enrolling students. Creating and documenting the progression of care as determined by the DSM V
- Accurately document the medical necessity and level of care based on evidence-based criteria.
- Detailed charting and accurately documenting students' conditions, criteria, medical necessity, risks, etc.
- Determining if the medical necessity for admission is appropriate, justifiable, and reimbursable.
- Completing concurrent utilization reviews for continued approval of authorizations
- Communicating with the home office and UR1 each student's level of care each student and determining the frequency of future reviews
- Completing and updating student treatment plans. Uploading treatment plans and required paperwork to the AHCCCS and Amity Foundation databases
- Maintaining a detailed spreadsheet listing when paperwork is submitted and what is needed for authorizations
- Utilize negotiation skills, which effectively promote constructive solutions
- Attend daily meetings with the team to ensure open communication and all tasks are getting completed
- Other duties as assigned by supervisor
- Hands-on knowledge of medical/behavioral health terminology
- High School diploma or GED
- Relevant accounting experience required. 3-5 years preferred
- Analytical and problem-solving skills
- Excellent interpersonal communication, problem-solving, and conflict resolution skills
- Computer skills in word processing, database management, and spreadsheet desirable.
- Proficiency with MS Office, including Word, Excel, and Outlook
- 100% Employer-Sponsored HMO Medical
- PPO, Dental & Vision options
- Paid Vacation, Sick time, & Holidays
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Job Summary
Full Time
Civic & Environmental Advocacy
$58k-77k (estimate)
10/24/2023
06/26/2024
amityfdn.org
DEARBORN HEIGHTS, MI
200 - 500
1969
Private
AMAD ELZAYAT
$5M - $10M
Civic & Environmental Advocacy
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The job skills required for Utilization Review Specialist include Utilization Management, Problem Solving, etc. Having related job skills and expertise will give you an advantage when applying to be an Utilization Review Specialist. That makes you unique and can impact how much salary you can get paid. Below are job openings related to skills required by Utilization Review Specialist. Select any job title you are interested in and start to search job requirements.
The following is the career advancement route for Utilization Review Specialist positions, which can be used as a reference in future career path planning. As an Utilization Review Specialist, it can be promoted into senior positions as an Utilization Review Manager - Home Care that are expected to handle more key tasks, people in this role will get a higher salary paid than an ordinary Utilization Review Specialist. You can explore the career advancement for an Utilization Review Specialist below and select your interested title to get hiring information.
If you are interested in becoming an Utilization Review Specialist, you need to understand the job requirements and the detailed related responsibilities. Of course, a good educational background and an applicable major will also help in job hunting. Below are some tips on how to become an Utilization Review Specialist for your reference.
Step 1: Understand the job description and responsibilities of an Accountant.
Quotes from people on Utilization Review Specialist job description and responsibilities
Utilization Review Specialists ensure that Doctors and Nurses choose only the best treatments for them.
03/11/2022: Fort Myers, FL
Utilization review typically refers to the review of services that have already been delivered, while utilization management often refers to the review of coverage for future medical services.
02/16/2022: Louisville, KY
Assess plans for patient care and determine what treatment is appropriate and most cost-effective
02/15/2022: Augusta, GA
Analyze electronic medical records, and inform medical staff whether a medical claim is denied,
03/11/2022: Boston, MA
Prepares and submits regular reports on utilization control and on review activities.
02/26/2022: Reading, PA
Step 2: Knowing the best tips for becoming an Accountant can help you explore the needs of the position and prepare for the job-related knowledge well ahead of time.
Career tips from people on Utilization Review Specialist jobs
Know where to find utilization review jobs.
03/13/2022: Clarksville, TN
Create a utilization review cover letter.
02/18/2022: Reno, NV
Sign up for free credit monitoring.
03/16/2022: New London, CT
Set up documentation shortcuts.
03/05/2022: Lawton, OK
Take the certification examination.
05/08/2022: New Bedford, MA
Step 3: View the best colleges and universities for Utilization Review Specialist.
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