Company: Aliso Ridge Behavioral Health & Anaheim Community
Location: Aliso Viejo
Posted on: May 26, 2023
DESCRIPTION OF POSITION: Work as member of multi-disciplinary
treatment team reviewing patient care and treatment options for
both inpatient and outpatient services. Proactively monitor and
optimize reimbursement for external reviewers/third party payers.
- Admissions: Conduct admission reviews.
- Concurrent/Stay Reviews: Conduct concurrent and extended stay
- Payment Appeals: Prepare and submit appeals to third party
- Recordkeeping: Maintains appropriate records of the Utilization
- Training: Provide staff in-service training and education.
- Maintains confidentiality of patients at all times.
- Ability to cope well with stress and have a strong sense of
- Sensitivity to and willingness to interact with persons of
various social, cultural, economic and educational
- Proficiency with software and/or equipment (Microsoft Office
applications including Outlook, Word, Excel and PowerPoint).
- Strong organizational skills with ability to prioritize
projects, work relatively independently, manage multiple tasks, and
- Strong written and verbal communication skills.
- Strong interpersonal skills: ability to work with people with a
variety of background and educational levels.
- Ability to work independently and as part of a team.
- Good judgment, problem-solving and decision-making skills.
- Demonstrated commitment to working collaboratively as well as
possessing the skills to lead, influence, and motivate others.
- Ability to work in a fast-paced, expanding organization.
Minimum Requirements: Education and Licensing:
- Current license as RN, LVN/LPT, LCSW,
- Preferred; Master's degree in Social Work, Behavioral Science,
or related field.
- Current CPR certification.
- Crisis Prevention Intervention (CPI) (or equivalent as approved
by CNO) obtained within 60 days of hire. Knowledge and Experience:
- Demonstrated knowledge of health care service delivery systems
and third-party reimbursement
- Two or more years' experience working in managed care
- Ability to apply and interpret admission and continued stay
- Strong understanding of admission and discharge function
- Familiarity with medical terminology, diagnostic terms and
- Knowledge of medical record-keeping requirements
- Ability to comprehend psychiatric evaluations, consults, and
lab results Skills and Abilities: Requirements Physical
Requirements: While performing the duties of this job, this
position is frequently required to do the following:
- Use standard office equipment and access, input, and retrieve
information from a computer. Use computer keyboard with manual and
finger dexterity and wrist-finger speed sufficient to perform
repetitive actions efficiently for extended periods of time.
- Communicate effectively in person or via telephone in a manner
which can be understood by those with whom the person is speaking,
including a diverse population.
- Give and follow verbal and written instructions with attention
to detail and accuracy.
- Perform complex mental functions and basic arithmetic
functions; interpret complex laws, regulations, and policies;
collect, interpret, and/or analyze complex data and
- Vision: See details of objects at close range.
- Coordinate multiple tasks simultaneously.
- Reach forward, up, down, and to the side.
- Sit or stand for minimum periods of one hour at a time and come
and go from the work area repeatedly throughout the day.
- Lift up to twenty five (25) pounds. Benefits
- Medical, Dental and Vision
- Voluntary Benefits
- Health Saving
- PTO Salary: $20.89 - $29.13 per hour
Keywords: Aliso Ridge Behavioral Health & Anaheim Community , Aliso Viejo , Utilization Specialist, Other , Aliso Viejo, California
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