Utilization Review Clinician (Non-Remote) (Santa Rosa) in California

POSITION TITLE: Utilization Review Clinician

REPORTS TO (TITLE): Director of Utilization Review

DESCRIPTION OF POSITION:

Work as member of multi-disciplinary treatment team reviewing patient care and treatment options for both inpatient and outpatient services. Proactively monitor and optimize reimbursement for external reviewers/third party payers.

KEY RESPONSIBILITIES:

• Admissions: Conduct admission reviews.
• Concurrent/Stay Reviews: Conduct concurrent and extended stay reviews.
• Payment Appeals: Prepare and submit appeals to third party payers.
• Recordkeeping: Maintains appropriate records of the Utilization Review Department.
• Training: Provide staff in-service training and education.
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