What are the responsibilities and job description for the Utilization Review Manager (PRN) position at Assurance Health System?
Company Description Assurance Health System is a regional network of short-term, inpatient psychiatric hospitals dedicated to meeting the mental health needs of older adults. The organization provides specialized, compassionate psychiatric care tailored to the unique needs of the senior population. With hospitals located in Indiana, Ohio, and Kansas, Assurance Health collaborates closely with long-term care facilities, assisted and independent living communities, and area hospitals. The system also partners with psychiatrists, geriatricians, internists, family practitioners, and other healthcare professionals to ensure coordinated, high-quality care.
Role Description The Utilization Review Manager (PRN) is responsible for reviewing patient clinical information to determine appropriate levels of care, medical necessity, and continued stay criteria for behavioral health services. This PRN role supports the organization on an as-needed basis and is performed remotely. Day-to-day tasks include conducting concurrent and retrospective reviews, preparing documentation for payers, and ensuring compliance with regulatory and payer guidelines. The Utilization Review Manager communicates with clinical teams, physicians, and external payers to resolve authorization issues and supports optimal patient flow and length of stay management. The role also involves maintaining accurate records, participating in quality improvement initiatives, and staying current with utilization review standards and best practices.
Qualifications
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- Prior experience in utilization review, case management, or managed care is highly beneficial.
- Proficiency in electronic health records and standard office software, with strong written and verbal communication skills.
- Ability to work independently in a remote environment, manage time effectively, and maintain confidentiality and compliance with all regulations.