Job Information
Acadia Healthcare Director-Utilization Management in Norcross, Georgia
Description
Conduct admission and concurrent reviews for assigned program patients; obtain admission information and insurance verification/benefits information from the Admissions Department.
Reviews charts and conducts pre-certification reviews with third party payors as required within specified time limits.
Communicates results of reviews to physicians and treatment team members.
Serves as liaison to on-site external reviews.
Maintains relevant reports and data for UR Department.
Completes all paperwork related to pre-certification and concurrent reviews according to UR policies.
Daily communication with physicians, treatment team and Business Office regarding certification and denials.
Coordinate and participate in the treatment planning process.
Monitor documentation, discharge planning process providing feedback on documentation processes.
Conducts ongoing reviews of clinical charts.
Facilitates Peer Review as outlined in Utilization Management Plan.
Administrative policies and procedures and a high level of confidentiality.
Qualifications
Education
Preferred
Associates or better in Nursing/Healthcare
Masters or better in Social Work
Masters or better in Psychology
Equal Opportunity Employer/Protected Veterans/Individuals with Disabilities
The contractor will not discharge or in any other manner discriminate against employees or applicants because they have inquired about, discussed, or disclosed their own pay or the pay of another employee or applicant. However, employees who have access to the compensation information of other employees or applicants as a part of their essential job functions cannot disclose the pay of other employees or applicants to individuals who do not otherwise have access to compensation information, unless the disclosure is (a) in response to a formal complaint or charge, (b) in furtherance of an investigation, proceeding, hearing, or action, including an investigation conducted by the employer, or (c) consistent with the contractor’s legal duty to furnish information. 41 CFR 60-1.35(c)
