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Utilization Review Specialist

Company: University of Arkansas for Medical Sciences
Location: Little Rock
Posted on: November 10, 2019

Job Description:

Job Details Company Overview The Utilization Review Specialist Works directly under the supervision of the WFC Program manager to perform daily utilization management tasks with Medicaid and other insurers. The University of Arkansas for Medical Sciences (UAMS) has a unique combination of education, research, and clinical programs that encourages and supports teamwork and diversity. We champion being a collaborative health care organization, focused on improving patient care and the lives of Arkansans. UAMS offers amazing benefits and perks: - Health: Medical, Dental and Vision plans available for staff and family - Holiday, Vacation and Sick Leave - Education discount for staff and dependents (undergraduate only) - Retirement: Up to 10% matched contribution from UAMS - Basic Life Insurance up to $50,000 - Career Training and Educational Opportunities - Merchant Discounts - Concierge prescription delivery on the main campus when using UAMS pharmacy Salary offered commensurate with experience Responsibilities - Creates Master treatment plan and treatment plan reviews for WFC and WMHC. - Will (in conjunction with other UM) completes program Prior Authorizations including those for neuropsychology, and other related documentation that is required for treatment of Medicaid and private insurance clients. - Over-sees policies and procedures related to that task, as well as making recommendations regarding this system to the WFC Program Manager. - Completes audits and reports as assigned. - Participates in departmental and program trainings and staffing as required. - Develops and maintains organizational processes, which allow timely completion of all required work. - Educates oneself regarding Medicaid regulations and is available to educate clinical staff regarding these requirements. - Other duties as assigned: which may include phone calls with patients or insurance companies, writing letters to patients on behalf of the clinical staff, assisting in the discharge process of patients, or answering patient questions regarding insurance requirements or limitations. Qualifications Minimum Qualifications: - Master's degree in social work, counseling, or related field - Licensed in the state of Arkansas as a LCSW, LMSW, LAC or LPC - At least one (1) year of behavioral health experience, may include internships Preferred Qualifications: - One (1) years Utilization Management mental health experience in an out-patient setting - Knowledge of Mental health, Arkansas Medicaid, other private insurance requirements This position is subject to a pre-employment criminal background check and drug screen. A criminal conviction or arrest pending adjudication alone shall not disqualify an applicant except as provided by law. Any criminal history will be evaluated in relationship to job responsibilities and business necessity. The information obtained in these reports will be used in a confidential, non-discriminatory manner consistent with state and federal law. UAMS is an URL blocked - click to apply and URL blocked - click to apply of individuals with disabilities and protected veterans and is committed to excellence. Physical Requirements Stand: Occasionally Sit: Frequently Walk: Occasionally Bend, crawl, crouch, kneel, stoop, or reach overhead: Occasionally Lift, push, pull, carry weight: 10 lbs or less Use hands to touch, handle, or feel: Occasionally Talk: Frequently Hear: Frequently Taste or smell: Never Read, concentrate, think analytically: Frequently Physical Environment: Inside Office Environment Noise Level: Quiet Visual Requirements: Far visual acuity, Near visual acuity Hazards: None Recommended skills Utilization Management Mental Health Licensed Clinical Social Worker (Lcsw) Behavioral Health Licensed Master Social Worker Medicaid

Keywords: University of Arkansas for Medical Sciences, Little Rock , Utilization Review Specialist, Other , Little Rock, Arkansas

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