Utilization Review Assistant - Hybrid Position (In State)
Company: Santa Fe Recovery Center
Location: Santa Fe
Posted on: May 26, 2023
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Job Description:
Description:Santa Fe Recovery Center (SFRC) is searching for the
right candidate who believes that everyone deserves access to
quality, evidence-based substance use treatment and that recovery
is possible. The candidate should have a clear vision of why they
want to work for us are wanting to grow and learn, and have a
desire to serve diverse populations and underserved
communities.Under the direct supervision of the Deputy Clinical
Director, the Utilization Review Assistant will work to ensure that
all requirements of the prior authorization and concurrent review
processes are completed in compliance with managed care guidelines
and expectations. The Utilization Review Assistant will work to
ensure that ASAM dimensional criteria are met in accordance with
recommended levels of care and will work as part of a close,
multidisciplinary team to ensure the best clinical outcomes are
achieved. The Utilization Review Assistant will also work to
coordinate aftercare and communicate case management needs to
therapists and referral agencies. Under close supervision, the
Utilization Review Assistant processes prior authorization and
concurrent stay requests for Medicaid and private insurance for
clients entering treatment and throughout the course of treatment
at Santa Fe Recovery Center.WORK PERFORMED:Begins the insurance
verification process for clients entering into subacute
detoxification, or residential prior to client admission. If prior
authorization is required, the UR Assistant will complete medical
necessity reviews based on available clinical information.Works
closely with direct supervisor, clinical team, financial team and
billing specialists to ensure timely preauthorization and
concurrent review processes are completed and documented
appropriately.Works with clinicians and physicians to ensure clear
diagnoses and treatment documentation required by MCO and insurers
including clinical and medical necessity for
treatment.Requirements:A Bachelor's Degree (Master's degree
preferred) from an accredited college or university in Nursing,
Psychology, Social Work, Addiction Medicine or Alcohol/Drug
Counselling.Current dependent license as: LBSW, LMSW, LMHC, LSAA,
LAMFT, LPN or ability to be licensed within 9 months of
hire.Current independent licensure: LPCC, LCSW, LADAC, LMFT or RN
preferred.ASAM Certified preferred.Two years of experience working
with clients with co-occurring mental health/substance abuse issues
preferred.Two years of experience working in an inpatient setting
such as a hospital, nursing facility, residential program, or
jail/prison preferred.In the case of a recovering person, he/she
must have successfully maintained a 3-year period of uninterrupted
abstinence from alcohol and/or drugs.Must be computer literate in
order to effectively maintain compliance with standards and
requirements for use of computerized client
assessments.PM21PI217595411
Keywords: Santa Fe Recovery Center, Santa Fe , Utilization Review Assistant - Hybrid Position (In State), Other , Santa Fe, New Mexico
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