Utilization Review Specialist- LPN or Social Worker
Company: Vermilion Behavioral Health
Posted on: January 11, 2022
Vermilion Behavioral Health Systems provides a comprehensive
benefits package which currently include:
Medical, dental, and vision insurance
Acadia Healthcare 401(k) plan
Excellent training program
Professional growth opportunity that is second to none in the
industry. Join a team with defined career paths and a national
family of hospitals and facilities
SHIFTS AND HOURS:
UR typically works Monday-Friday normal business hours.
Essential Job Functions:
Act as liaison between managed care organizations and the
facility's 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
Inform clinical and medical staff of any specific concerns that
would extend or restrict the length of stay of patients.
Keep accurate record of all contact with external organizations and
persons who have legitimate interest and legal access to
information on the care of patients.
Facilitate peer review calls between facility and external
Act in coordination with the leadership team of the facility or
corporate office to improve the quality of services provided within
Assist the admissions department with pre-certifications of
Initiate and complete the formal appeal process for denied
admissions or continued stay.
Provide ongoing support and training for staff on documentation or
charting requirements, continued stay criteria and medical
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.
Equal Opportunity Employer/Protected Veterans/Individuals with
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
Keywords: Vermilion Behavioral Health, Lafayette , Utilization Review Specialist- LPN or Social Worker, Healthcare , Lafayette, Louisiana
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