Utilization Review Specialist

Responsibilities Texas NeuroRehab Center is a specialized treatment facility located ten minutes from downtown Austin on 67 wooded acres. Originally a cattle ranch, the land was purchased in 1943 as part of The Brown Schools and has operated as a medical rehabilitation and behavioral healthcare facility for over 80 years. Today, Texas NeuroRehab Center provides complex medical and brain and spinal cord injury rehab for ages 13 years and older and neuropsychiatric treatment for youth. The capabilities of the facility as a whole allow for integrated and specialized care for children, adolescents and adults facing difficult challenges. Texas NeuroRehab Center is internationally known for improving the quality of life for many children; adolescents and adults, and it will continue to provide innovative approaches to neurobehavioral healthcare. Website: Texas NeuroRehab Center is currently accepting applicants for a Utilization Outcomes Specialist. This candidate will supervises and coordinates the clinical review of patients for optimal customer satisfaction and resource utilization. Ensure that documentation meets requirements of regulatory and licensing groups. Ensures the UM plan meets requirements of regulatory and licensing groups. Benefits For This Position Include Challenging and rewarding work environment Flexible Scheduling options SoFi Student Loan Refinancing Program Career development opportunities within UHS and its 300+ Subsidiaries! Challenging and rewarding work enviornment Qualifications SKILLS KNOWLEDGE AND ABILITIES: Knowledge of rehabilitation, psychiatric, and/or neurobehavioral patient services. Professional verbal and written skills needed for communicating the patient status, and treatment needs to payers, families, professionals, paraprofessional employees of the hospital, and members of the patient's community. Able to maintain professional records and patient confidentiality. Knowledge of case management functions, and insurance payor criteria for meeting medical necessity. Strong written and verbal communication skills. Able to work collaboratively and diplomatically in problem identification and problem solving. Able to interpret written contracts and standards, and implement requirements. Basic understanding of regulatory requirements related to Utilization Management, JCAHO, and reimbursement. Works independently with little supervision. Understands human resource management principles and requirements. EDUCATION: Bachelor's degree in human services with 5 years of experience, or Master's degree with three years of experience in utilization review or case management functions. LICENSURE/CERTIFICATION: Current Driver’s License or State issued Id required. Professional License preferred. Established licenses are to be maintained. EXPERIENCE: Utilization review experience requiring verbal and written communication; prioritizing and addressing multiple tasks; and working with a team approach. Experience in working with children, adolescents, and/or adults with neurobehavioral, psychiatric, and/or neuro-psychiatric diagnoses requiring treatment. Five years with bachelor’s degree or three years with master’s degree. PHYSICAL/GENERAL REQUIREMENTS: Able to sit or stand while interacting with patients, families, and staff. Able to write/type for extended periods of time. Able to travel between various hospital areas. Able to use telephone for extended periods of time. Able to deal with stressful situations and changing priorities. Able to sustain physical activity eight hours a day. Able to remain on feet eight hours per day. Able to lift, carry, and lower 25 pounds without assistance. Able to push patients in wheel chairs up and down hills and pursue running patients. Able to transfer patients to and from wheel chairs. Able to confront a dangerous and aggressive patient. Able to verbally communicate to de-escalate a crisis situation and accurately convey patient behavior and status. Able to visually observe to convey verbally or in writing patient behavior or to protect self and others from aggressive patients or other accidents. Able to write legibly and grammatically to convey patient behavior and information in the patient chart. Able to eat with and feed patients. Regular and expected attendance. Hearing and vision sufficient to perform essential job functions. Emotional stability and ability to deal with changing priorities. Able to physically restrain patients by individual or team restraint per hospital policy. EEO Statement All UHS subsidiaries are committed to providing an environment of mutual respect where equal employment opportunities are available to all applicants and teammates. UHS subsidiaries are equal opportunity employers and as such, openly support and fully commit to recruitment, selection, placement, promotion and compensation of individuals without regard to race, color, religion, age, sex (including pregnancy, gender identity, and sexual orientation), genetic information, national origin, disability status, protected veteran status or any other characteristic protected by federal, state or local laws. We believe that diversity and inclusion among our teammates is critical to our success. #J-18808-Ljbffr