RN - Utilization Review Manager

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RN – Utilization Review Manager

Arkansas Licensed RN for Utilization Review Manager. Position available in numerous clinics throughout Arkansas.  Please refer to our website at www.DaySpringbhs.com for a complete listing of our DaySpring locations. Microsoft Word and Excel experience preferred. Offers Competitive Pay & Great Benefits! 

 

Job Qualifications: Eligibility for this position requires a Bachelor’s degree from an accredited program in nursing or other health-related field, and at least one year of supervised training/experience in a psychiatric/behavioral health setting.  All Licensed Practical Nurses and Registered Nurses must be licensed within their profession by their respective Arkansas State Boards.

 

Supervised by: Utilization Review Manager will be jointly supervised by the Program Coordinator, Medical Director and other staff Physician(s); with specific Utilization Review activities supervised by the Utilization Review Director.  

 

Positions Supervised:  None.

 

Job Expectations: All Utilization Review Managers are expected to perform the following functions:Provide all services and functions within the ethical standards of their profession, within their Scope of Practice guidelines, and within the DaySpring Code of Conduct.Adhere to all company policies for employment.Provide a minimum of 12 to 15 hours of billable services per week, primarily through services such as medical case management, in conjunction with services provided by the DaySpring Clinic Physician.Assist in scheduling Physician appointments, preparing medical records for Physician visits, and resolving Client concerns regarding medication issues which arise between Physician visits.Provide other essential, non-billable functions such as communicating with Clients, Physicians, and Pharmacies as needed.Manage all regulatory registrations, authorizations, denials and appeals for RSPMI services, including tracking utilization of services, informing Client’s treatment team members of authorization status and other pertinent information.Review all clinical documentation for quality assurance before submission for billing, to verify medical necessity, completeness, accuracy, and content, thus satisfying regulatory compliance.  Track and report trends in service utilization, identifying areas needing improvement to the Utilization Review Director.Assist with on-site regulatory audits as needed. Provide professional clinical services to DaySpring clients, as assigned, including assessment, referral, treatment planning, counseling, crisis intervention, crisis stabilization, and discharge planning.Complete all clinical and administrative documentation in a timely and ethical manner and in accordance with DaySpring policies.

 

 

Interested parties can email resume to Human Resources at

DLSmith@dayspringbhs.com or fax to 501-336-0115