Utilization Review Specialist

Join PrairieCare: Transform Lives Through Meaningful Work!

Are you ready to embark on a rewarding career in psychiatric healthcare? At PrairieCare, we are passionate about delivering exceptional mental health services to individuals in need. Our comprehensive approach covers the entire spectrum of care, creating a wealth of diverse roles for those who aspire to make a real impact.

We believe in nurturing talent and fostering professional growth in a supportive environment. Here, you won't just find a job-you'll discover a fulfilling career path in the mental health field.

If you're eager to contribute to a mission-driven organization and help change lives for the better, we invite you to join our dedicated team at PrairieCare. Together, we can make a profound difference in the lives of those we serve!

Join Our Dynamic Team as a Utilization Review Specialist

Are you passionate about making a difference in the lives of those with psychiatric illnesses? Do you thrive in a collaborative environment where your expertise can shine? If so, we have the perfect opportunity for you!

What You'll Do: As our Behavioral Health Liaison, you will be the vital link between our dedicated clinical treatment team and third-party payers, ensuring that every patient receives the appropriate treatment they deserve. Your role will include:

Securing Authorizations: Obtain initial behavioral health authorizations and conduct thorough concurrent reviews to keep our patients on the path to recovery.

Collaborative Decision-Making: Work closely with the clinical treatment team to assess the need for denial of stay when patients no longer meet acute care criteria, facilitating timely and appropriate actions.

Stay Informed: Maintain an up-to-date understanding of contract requirements for all third-party payor groups, ensuring compliance and optimal patient care.

Track Progress: Monitor each patient's treatment journey through inpatient, partial hospitalization, and Intensive Outpatient Programs (IOP), ensuring they receive the best possible support.

Cultural Competence: Bring your knowledge of gender, cultural differences, and age-appropriate care to the forefront of Utilization Review, enhancing our approach to diverse patient needs.

Why Join Us? At our organization, you'll be part of a passionate team committed to improving mental health care. We value your expertise and provide ongoing training and support to help you excel in your role.

Make a Difference Today! If you're ready to take on a rewarding challenge and be a champion for those in need, apply now and help us transform lives through compassionate care!

Your journey to making a meaningful impact starts here!

We are excited to hear about your interest in this opportunity! If you have any questions or need assistance with the application process, please feel free to contact me directly at Sydney Spencer, either via email at sydney.spencer@newporthealthcare.com or by phone at 615-961-4138. If you need further support, you are also welcome to reach out to our careers and management team at careers@newporthealthcare.com.

What You'll Bring:

• Requires knowledge of nursing practices, which can be gained only through an accredited school of nursing. Current licensure with the Minnesota State Board of Nurse Examiners is required.
• Required to be knowledgeable of and follow the Nurse Practice Act
• Previous utilization review experience preferred
• Knowledge of UR Standards of Excellence
• Display a professional attitude in all aspects of nursing performance
• Must be proficient in using Microsoft Office Products including Word and Outlook.

Compensation for this role ranges from $35-$45 per hour depending on education and experience.

We are committed to providing competitive and equitable compensation. An individual's pay rate within the posted range is determined by several factors, including skills, experience, education, and market conditions. Additionally, we consider internal equity to ensure fairness within our organization.

Benefit options include:

• Medical/Dental/Vision
• Company paid life insurance
• Paid time off including sick time
• Voluntary Short term and long-term disability
• 401K with company match
• Flexible spending accounts
• Tuition Reimbursement
• Student Loan Repayment
• Free parking
• Free 24/7 Fitness Center

Join Us:

Join us in our mission to provide outstanding support and make a meaningful difference in the lives of those we assist. Your contributions can help shape the future of our care services-apply today!

PrairieCare Healthcare is an Equal Opportunity Employer.

PrairieCare provides equal employment opportunities to all employees and applicants for employment and prohibits discrimination and harassment of any type without regard to race, color, religion, age, sex, sexual orientation, gender identity, national origin, disability status, protected veteran status, genetic information, or any other characteristic protected by federal, state, or local laws.

PrairieCare is committed to ensuring equal employment opportunity, including providing reasonable accommodations to individuals with disabilities. Applicants with a physical or mental disability who require a reasonable accommodation for any part of the application or hiring process are encouraged to email accommodations@prairiecare.com for assistance.

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