Community Health Systems

Utilization Review Clinical Specialist - Behavioral Health (Remote)


PayCompetitive
LocationFranklin/Tennessee
Employment typeFull-Time

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  • Job Description

      Req#: UTILI299332
      Employer Industry: Healthcare Services

      Why Consider this Job Opportunity:
      - Competitive pay up to $80,000 per year
      - Opportunity for career advancement and professional growth within the organization
      - Comprehensive benefits package including health insurance and retirement plans
      - Flexibility to work remotely
      - Supportive and collaborative work environment
      - Chance to make a positive impact on patient care and outcomes

      What to Expect (Job Responsibilities):
      - Conduct initial clinical assessments and continued stay assessments using evidence-based criteria
      - Collaborate with physicians to obtain necessary documentation to support medical necessity
      - Document all actions and activities in the case management software system
      - Coordinate Peer to Peer discussions for concurrent denials
      - Communicate effectively with insurance providers and case managers for reviews and authorizations

      What is Required (Qualifications):
      - Associates Degree in Nursing
      - At least 3 years of previous psych nursing experience
      - Licensed Practical Nurse or Licensed Registered Nurse
      - Data entry skills and proficiency in Google Docs, Google Sheets, and email applications
      - Ability to prioritize assignments and demonstrate effective time-management skills

      How to Stand Out (Preferred Qualifications):
      - 3 plus years of Utilization review experience
      - ACM or CCM Certification
      - Basic knowledge of clinical and psychosocial aspects of patient care
      - Detail-oriented, flexible, and committed to patient advocacy
      - Excellent verbal and written communication skills

      #HealthcareServices #PatientCare #UtilizationReview #RemoteWork #CareerGrowth

      We prioritize candidate privacy and champion equal-opportunity employment. Central to our mission is our partnership with companies that share this commitment. We aim to foster a fair, transparent, and secure hiring environment for all. If you encounter any employer not adhering to these principles, please bring it to our attention immediately.
      We are not the EOR (Employer of Record) for this position. Our role in this specific opportunity is to connect outstanding candidates with a top-tier employer.
  • About the company

      Community Health Systems is a Fortune 500 company based in Franklin, Tennessee.