Utilization Review Specialist - $5,000 Sign-on!
San Jose, CA San Jose, CA Full-time Full-time $29 - $44 an hour $29 - $44 an hour 3 days ago 3 days ago 3 days ago New Unit Opening Soon - Multiple Flexible Shift Opportunities Available San Jose Behavioral Health is an 80-bed inpatient mental health facility where adults and adolescents can receive comprehensive inpatient treatment for a range of behavioral and mental health disorders.
Conveniently located in the heart of San Jose the hospital is easily accessible to residents in Santa Clara County, San Mateo County, and Alameda County.
The Hospital campus is situated amid gently rolling hills and features serene views of beautiful natural surroundings.
Our supportive work environment is focused on sharing knowledge and expertise to help you get acclimated to your new role.
Along with detailed training and continual support, our company will give you the autonomy you need to achieve your career goals.
You already are passionate and caring about the patients.
We will provide the same passion and attitude towards you San Jose Behavioral Health is part of Acadia Healthcare, a leading provider of behavioral healthcare services across the United States.
Acadia operates a growing network of 230 plus behavioral healthcare facilities with approximately 10,200 beds in 40 states and Puerto Rico.
With more than 20,000 employees serving approximately 70,000 patients daily, Acadia is the largest stand-alone behavioral health company in the U.
S.
Great opportunity for an experienced LPN/LVN/SOCIAL WORKER! ELIGIBLE FOR $5,000 SIGN ON BONUS
Essential Functions:
Act as liaison between managed care organizations and the facility 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 requirements.
Monitor patient length of stay and extensions and inform clinical and medical staff on issues that may impact length of stay.
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.
Conduct quality reviews for medical necessity and services provided.
Facilitate peer review calls between facility and external organizations.
Initiate and complete the formal appeal process for denied admissions or continued stay.
Assist the admissions department with pre-certifications of care.
Provide ongoing support and training for staff on documentation or charting requirements, continued stay criteria and medical necessity updates.
EDUCATION/EXPERIENCE/SKILL REQUIREMENTS:
Associate's degree in nursing (LPN or RN) required.
Bachelor's or Master's degree in social work, behavioral or mental health, nursing or other related health field preferred.
Two or more years' experience with the population of the facility and previous experience in utilization management preferred.
LICENSES/DESIGNATIONS/CERTIFICATIONS:
Current licensure as an LPN or RN within the state where the facility provides services; or current clinical professional license or certification, as required, within the state where the facility provides services.
CPR and de-escalation and restraint certification required (training available upon hire and offered by facility.
First aid may be required based on state or facility requirements.
Compensation for roles at San Jose Behavioral Health varies depending on a wide array of factors including but not limited to the specific location, role, skill set, and level of experience.
As required by local law, San Jose Behavioral Health provides a reasonable hourly range of compensation for roles that may be hired in California as set forth below.
Role Location:
San Jose, California Calculated Hourly Range for role California:
$29-44 Job Type:
Full-time Pay:
$29.
00 - $44.
00 per hour
Benefits:
401(k) Dental insurance Health insurance Life insurance Paid time off Vision insurance Medical specialties:
Medical-Surgical Physical setting:
Acute care Clinic Hospital Inpatient Long term care Nursing home Outpatient Rehabilitation center Schedule:
8 hour shift Weekend availability Supplemental pay types:
Bonus pay Signing bonus Ability to commute/relocate:
San Jose, CA 95138:
Reliably commute or planning to relocate before starting work (Required) License/Certification:
LPN/LVN (Required) Work Location:
In person.
Estimated Salary: $20 to $28 per hour based on qualifications.
Conveniently located in the heart of San Jose the hospital is easily accessible to residents in Santa Clara County, San Mateo County, and Alameda County.
The Hospital campus is situated amid gently rolling hills and features serene views of beautiful natural surroundings.
Our supportive work environment is focused on sharing knowledge and expertise to help you get acclimated to your new role.
Along with detailed training and continual support, our company will give you the autonomy you need to achieve your career goals.
You already are passionate and caring about the patients.
We will provide the same passion and attitude towards you San Jose Behavioral Health is part of Acadia Healthcare, a leading provider of behavioral healthcare services across the United States.
Acadia operates a growing network of 230 plus behavioral healthcare facilities with approximately 10,200 beds in 40 states and Puerto Rico.
With more than 20,000 employees serving approximately 70,000 patients daily, Acadia is the largest stand-alone behavioral health company in the U.
S.
Great opportunity for an experienced LPN/LVN/SOCIAL WORKER! ELIGIBLE FOR $5,000 SIGN ON BONUS
Essential Functions:
Act as liaison between managed care organizations and the facility 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 requirements.
Monitor patient length of stay and extensions and inform clinical and medical staff on issues that may impact length of stay.
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.
Conduct quality reviews for medical necessity and services provided.
Facilitate peer review calls between facility and external organizations.
Initiate and complete the formal appeal process for denied admissions or continued stay.
Assist the admissions department with pre-certifications of care.
Provide ongoing support and training for staff on documentation or charting requirements, continued stay criteria and medical necessity updates.
EDUCATION/EXPERIENCE/SKILL REQUIREMENTS:
Associate's degree in nursing (LPN or RN) required.
Bachelor's or Master's degree in social work, behavioral or mental health, nursing or other related health field preferred.
Two or more years' experience with the population of the facility and previous experience in utilization management preferred.
LICENSES/DESIGNATIONS/CERTIFICATIONS:
Current licensure as an LPN or RN within the state where the facility provides services; or current clinical professional license or certification, as required, within the state where the facility provides services.
CPR and de-escalation and restraint certification required (training available upon hire and offered by facility.
First aid may be required based on state or facility requirements.
Compensation for roles at San Jose Behavioral Health varies depending on a wide array of factors including but not limited to the specific location, role, skill set, and level of experience.
As required by local law, San Jose Behavioral Health provides a reasonable hourly range of compensation for roles that may be hired in California as set forth below.
Role Location:
San Jose, California Calculated Hourly Range for role California:
$29-44 Job Type:
Full-time Pay:
$29.
00 - $44.
00 per hour
Benefits:
401(k) Dental insurance Health insurance Life insurance Paid time off Vision insurance Medical specialties:
Medical-Surgical Physical setting:
Acute care Clinic Hospital Inpatient Long term care Nursing home Outpatient Rehabilitation center Schedule:
8 hour shift Weekend availability Supplemental pay types:
Bonus pay Signing bonus Ability to commute/relocate:
San Jose, CA 95138:
Reliably commute or planning to relocate before starting work (Required) License/Certification:
LPN/LVN (Required) Work Location:
In person.
Estimated Salary: $20 to $28 per hour based on qualifications.
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