Utilization Specialist
Acadia Healthcare
Overview PURPOSE STATEMENT:
Proactively monitor utilization of services for patients to optimize reimbursement for the facility.
Responsibilities ESSENTIAL FUNCTIONS:
(e.g. emergencies, changes in workload, rush jobs or technological developments) dictate.
We are committed to providing equal employment opportunities to all applicants for employment regardless of an individual's characteristics protected by applicable state, federal and local laws.
Proactively monitor utilization of services for patients to optimize reimbursement for the facility.
Responsibilities ESSENTIAL FUNCTIONS:
- Act as liaison between managed care organizations and the facility professional clinical staff.
- Conduct reviews, in accordance with certification requirements, of insurance plans or other managed care organizations (MCOs) and coordinate the flow of communication concerning reimbursement requirements.
- Monitor patient length of stay and extensions and inform clinical and medical staff on issues that may impact length of stay.
- Gather and develop statistical and narrative information to report on utilization, non-certified days (including identified causes and appeal information), discharges and quality of services, as required by the facility leadership or corporate office.
- Conduct quality reviews for medical necessity and services provided.
- Facilitate peer review calls between facility and external organizations.
- Initiate and complete the formal appeal process for denied admissions or continued stay.
- Assist the admissions department with pre-certifications of care.
- Provide ongoing support and training for staff on documentation or charting requirements, continued stay criteria and medical necessity updates.
- Perform other functions and tasks as assigned.
- Required Education: High school diploma or equivalent.
- Preferred Education : Associate's, Bachelor's, or Master's degree in Social Work, Behavioral or Mental Health, Nursing, or a related health field.
- Experience: Clinical experience is required, or two or more years' experience working with the facility's population. Previous experience in utilization management is preferred
- Preferred Licensure: LPN, RN, LMSW, LCSW, LPC, LPC-I within the state where the facility provides services; or current clinical professional license or certification, as required, within the state where the facility provides services.
- CPR and de-escalation and restraint certification required (training available upon hire and offered by facility.
- First aid may be required based on state or facility requirements.
(e.g. emergencies, changes in workload, rush jobs or technological developments) dictate.
We are committed to providing equal employment opportunities to all applicants for employment regardless of an individual's characteristics protected by applicable state, federal and local laws.
Vacancy posted 1 day ago
Similar jobs that could be interesting for youBased on the Utilization Specialist in Conway, AR vacancy
- ...Utilization Management SpecialistProactively monitor utilization of services for patients to optimize reimbursement for the facility.Essential Functions:Act as liaison between managed care organizations and the facility professional clinical staff.Conduct reviews, in accordance...SuggestedWork at office
Acadia Healthcare
Conway, AR2 days ago - ...Acadia Healthcare is seeking a professional to proactively monitor service utilization and optimize reimbursement for the facility. You will liaise with managed care organizations, review plans, and coordinate communication on requirements, while monitoring length of stay...Suggested
Acadia Healthcare
Conway, AR4 days ago - ...Member Specialist Job Summary This position performs a variety of routine and advanced duties in support of growth, service goals and profitability for Field Sales within a Branch. Performs routine and advanced duties in support of agents and other personnel....SuggestedWork at office
AAA Auto Club Group
Conway, AR3 days ago - ...The Delivery Specialist will maintain and operate store vehicles to deliver parts and/or products to professional customers in a safe and efficient manner. This position will also collect money on C.O.D. deliveries and pick up customer returns. Bilingual candidates encouraged...SuggestedLocal areaImmediate startFlexible hours
O'Reilly Auto Parts
Conway, AR2 days ago - ...Delivery Specialist The Delivery Specialist will maintain and operate store vehicles to deliver parts and/or products to professional customers in a safe and efficient manner. This position will also collect money on C.O.D. deliveries and pick up customer returns....SuggestedLocal areaImmediate startRemote workFlexible hours
O'Reilly Auto Parts
Conway, AR1 day ago - ...ESSENTIAL JOB FUNCTIONS The Delivery Specialist will maintain and operate store vehicles to deliver parts and/or products to professional customers in a safe and efficient manner. This position will also collect money on C.O.D. deliveries and pick up customer returns....Local areaImmediate startFlexible hours
O'Reilly Automotive Stores
Conway, AR17 hours ago - ...O'Reilly Auto Parts is hiring a Delivery Specialist to operate company vehicles, deliver parts to customers, and collect COD payments. The role involves using handheld devices, maintaining vehicle readiness, and securing funds and returns. Bilingual candidates are encouraged...
O'Reilly Auto Parts
Conway, AR5 days ago - The Pointe at Conway in Conway, AR is seeking a friendly Leasing Consultant to join our team. You will meet with prospective residents, conduct tours, and help applicants secure leases while delivering exceptional resident service. Strong communication, customer service...
Rich Smith Management
Conway, AR1 day ago - ...Overview The Precertification Specialist is responsible for reviewing scheduled procedures and insuring that necessary precertification or authorization for services is obtained promptly and accurately. Qualifications High School Diploma or equivalent...Work experience placement
Conway Regional
Conway, AR2 days ago $17 - $25 per hour
Position Summary... What you'll do... Provides member service. Maintains the checkout area. Resolves member issues and concerns. Promotes Sam's Club products and services. Provides guidance and support to members regarding self-service technology. Processes member...Hourly payMinimum wageFull timeTemporary workPart timeWalmart
Conway, AR2 days ago- Hearing Aid SpecialistNationsBenefits is recognized as one of the fastest-growing companies in America and a Healthcare Fintech provider of supplemental benefits, flex cards, and member engagement solutions. We partner with managed care organizations to provide innovative...Full timeFlexible hours
NationsBenefits
Conway, AR1 day ago $17 - $25 per hour
...execution. Be a Techie: Leverages digital tools to drive sales, improve the shopping experience, and elevate associate engagement; utilizing handheld technology to make immediate business decisions related to production, training, and product quality with the member in...Hourly payMinimum wageFull timeTemporary workPart timeImmediate startFlexible hoursSam's Club
Conway, AR17 hours ago- Position Summary The Label & Specification Specialist will manage product specification and label design within a food and beverage manufacturing environment. This role is critical in ensuring compliance with food safety regulations, customer requirements, and internal...
$17 - $25 per hour
...execution. Be a Techie : Leverages digital tools to drive sales, improve the shopping experience, and elevate associate engagement; utilizing hand held technology to make immediate business decisions related to production, ordering merchandise, receiving club pick up...Hourly payMinimum wageFull timeTemporary workPart timeImmediate startFlexible hoursWalmart
Conway, AR5 days ago$17 - $25 per hour
...quality. Be a Techie: Leverages digital tools to drive sales, improve the shopping experience, and elevate associate engagement; utilizing hand held technology to make immediate business decisions related to production, training, and product quality with the member in...Hourly payMinimum wageFull timeTemporary workPart timeImmediate startFlexible hoursWalmart
Conway, AR5 days ago- ...Treasury Management Support Specialist The Treasury Management Support Specialist is responsible for back-office support of all corporate... ...bar graphs. Critical Thinking Skills Ability to utilize common sense understanding in order to carry out written, oral...Remote work
cen.ai
Conway, AR2 days ago $23 per hour
...mission‑driven culture that values contribution, encourages growth, and empowers employees to do meaningful work. Health & Wellness Specialist (On‑Site EMT/Medic) Location: Wheatley, AR Pay: $23/hour Schedule: Monday‑Friday 7:00 AM to 5:00 PM Job Type: Full‑time About...Daily paidFull timeImmediate startMonday to FridayFlexible hoursDay shiftWeekday work- ...Health Technician (Hearing Instrument Specialist) This position serves the Central Arkansas Veterans Healthcare System, Audiology and Speech Pathology Service in Little Rock, AR. The duties and responsibilities are to be carried out in all clinical and other patient...
- ...telecommunications construction projects by assisting with permit preparation, submittals, and tracking. You'll learn how to interpret utility construction drawings, understand Make Ready Engineering (MRE), and work with GIS mapping tools to help ensure projects move...Full timeTemporary workWork at office
$23 per hour
...Health & Wellness Specialist (On-Site EMT/Medic) Location: Wheatley, AR Pay: $23/hour Schedule: Monday-Friday 7:00AM to 5:00PM Join JobSiteCare, a physician-led company transforming healthcare on construction sites. We're looking for a proactive Health & Wellness...Daily paidFull timeMonday to FridayFlexible hoursShift workDay shiftWeekday work- Your Job Molex is seeking a dedicated and detail-oriented Electronics & Hardware Technician to join our team in Conway, AR. The ideal candidate will be responsible for conducting thorough electronics diagnose and debug of PCBAs, troubleshooting, conduct electrical and ...Flexible hours
Molex
Conway, AR17 hours ago $21 - $29 per hour
...supplies and merchandise from distribution centers and vendors throughout the facility and organizes and maintains the salesfloor by utilizing equipment merchandising and completing paperwork logs and other required documentation according to company policies...Hourly payMinimum wageFull timeTemporary workPart timeWalmart
Conway, AR1 day ago- Lincare in Conway, Arkansas is seeking a field-based equipment setup technician responsible for timely and professional installation of ventilators, monitors, CPAP units and oxygen equipment, often at patients' homes. The role includes providing technical assistance and...
- Location(s): Conway, ArkansasCompany: MolexCareer Field: EngineeringJob Number: 187081Apply: JobThe Prototype Lab Coordinator plays a critical role in supporting innovation, product development, and proof-of-concept (PoC) activities by coordinating procurement, logistics...Work at officeFlexible hours
- ...We are currently seeking a Billing Specialist to join our team of highly qualified professionals that share our vision of Empowering Children to Conquer their World! This role provides customer service and is responsible for all billing aspects associated with Pediatrics...Work at officeLocal area
Pediatrics Plus Website
Conway, AR1 day ago - ...with high speed, high density connectors, cable assemblies, and interconnect productsDesign experience with products manufactured utilizing electroplating and automated assemblyGood understanding and practical knowledge of Six Sigma quality development tools and principles...WorldwideFlexible hours
- ...cause analysis.Comply with all OSHA, NFPA, and company safety policies and procedures, including lockout/tagout.Support facility and utility maintenance tasks as assigned.Perform other duties as needed to support departmental and plant goals.Required Qualifications:High...Day shift
Westrock Coffee Company
Conway, AR4 days ago - Job Description Lot Associates assist customers with the loading of their vehicles and also monitor and maintain the entrance of the store. Lot Associates also are responsible for maintaining a sufficient quantity of carts near the entrance of the store. This position...Local area
Home Depot
Conway, AR2 days ago - US LBM is one of the leading and fastest growing distributors of specialty building materials in the United States, with a team of over 15,000 employees located throughout the country. Since our founding in 2009, we have acquired over 70 companies and have expanded to ...Full timeFor contractorsLocal areaShift work
US LBM Holdings LLC
Conway, AR1 day ago - Overview PURPOSE STATEMENT: Organize and prepare work schedules according to established nursing guidelines based on census and patient acuity for all nursing units and programs. Responsibilities ESSENTIAL FUNCTIONS: • Monitor census, staffing, scheduled...Local areaShift workWeekend work
Acadia Healthcare
Conway, AR1 day ago
Do you want to receive more vacancies?
Subscribe and receive similar vacancies to Utilization Specialist. Be the first to apply!
Related searches
- treasury specialist Conway, AR
- helpdesk specialist Conway, AR
- international relations specialist Conway, AR
- mental health specialist Conway, AR
- loss prevention specialist Conway, AR
- writing specialist Conway, AR
- executive protection specialist Conway, AR
- fabrication specialist Conway, AR
- lighting specialist Conway, AR
- credit specialist Conway, AR