We’re a physician-led behavioral healthcare company dedicated to providing evidence-based, expert care for addiction and mental health conditions. 

We work with healthcare providers, organizations and individuals to connect those in need to life-saving addiction treatment and mental health support that repairs lives, families and the surrounding communities.  We have 13 locations located across the United States.

Industry: Mental Health Care
Company Size: 1,001-5,000 employees

Advanced Recovery Systems, LLC

Savvy Admin PROD

We are looking for a **Remote Utilization Review Specialist**

Advanced Recovery Systems is an integrated behavioral healthcare management company dedicated to the treatment of addiction, substance abuse, eating disorders and mental health issues. We put behavioral health front and center, providing assistance to people with substance abuse issues, addictions and mental health concerns. With facilities in various regions of the U.S., we have been furthering this mission since our inception, applying our advanced approach to patient care.

Every facility in the Advanced Recovery Systems network strives to provide the highest quality of care, using evidence-based therapeutic models that really work. Our goal is to help men, women and adolescents live healthy, happy lives without the burden of substance abuse or mental illness.

The **Utilization Review Specialist ** (UR Specialist) is responsible for contacting external case managers/managed care organizations for pre-authorization and concurrent reviews throughout the duration of patient's treatment stay, and assists the treatment team in understanding the different requirements that various insurance companies have for admission, continued stay and discharge planning.

**Core Job Duties:**

- Completes pre-authorizations/concurrent reviews/internal UR reviews

- Consults with various members of the multidisciplinary treatment team concerning required information to complete concurrent reviews

- Schedules peer to peer reviews and coordinates urgent/expedited appeals

- Staffs individual cases with MDs as needed

- Follows all standard ARS Utilization Review Department policies and procedures

- Utilizes the UR Census Report on a daily basis

- Makes all initial calls within 24 hours, and follow up calls every 24 hours

- Data entry, records management and assisting with the appeals process

- Completing detailed daily documentation

- Works with Finance Department regarding client service authorizations

- Communicating frequently with the treatment team

- Other duties as assigned

**Requirements**

- Bachelor's degree in a health or behavioral health related field required, Graduate degree in a health or behavioral health related field preferred, OR

- High School diploma or equivalent and a State license (e.g., Registered Nurse, Licensed Practical Nurse, LCSW, LMHC) preferred

- Minimum of three years' experience working in a psychiatric or chemical dependency setting

- Minimum of three years' Utilization Review experience preferred

- State licensure preferred (Registered Nurse, Licensed Practical Nurse, Licensed Clinical Social Worker, Licensed Mental Health Counselor)

**Position Competencies:**

- Proficiency in establishing and maintaining positive and effective communication with managed care companies

- Ability to aligns medical and counseling staff to ensure services are provided at the appropriate level of care in a timely manner consistent with the patient's condition and in compliance with governmental and accrediting agencies

- Concurrent Reviews

- Utilization Review

- Census Report

- ASAM criteria Ability to be resourceful and proactive in dealing with issues that may arise

- Demonstrate the ability to organize, multitask, prioritize and work under pressure

- Effective time management

Advanced Recovery Systems, a national integrated behavior healthcare management company dedicated to the treatment of addiction, substance abuse, eating disorders and mental health issues. We invite you to learn more about us at our website!

The Company complies with state and federal nondiscrimination laws and policies that prohibit discrimination based on age, color, disability, national origin, race, religion, or sex. It is unlawful to retaliate against individuals or groups based on the basis of their participation in a complaint of discrimination or on the basis of their opposition to discriminatory practices/EEO

**We are proud to be a drug-free workplace.**

**Benefits**

**What we offer:**

- Starting pay $50,000/yr, based on experience

- Paid Time Off: Up to 2 weeks of paid time off per year plus sick pay & holiday pay

- Benefits begin on the 1st day of the month following date of hire

- Matching HSA - up to $1500/yr contribution from the company to your HSA

- 401(k), medical, dental, vision, and free Telehealth access

- Employee Referral Bonus - you can earn up to $4000

#indcorporatehiring

Utilization Review Specialist

Headquartered in Franklin, Tennessee, Acadia Healthcare was established in January 2005 to develop and operate a network of behavioral health facilities across the country.

Acadia Healthcare’s mission is to create a world-class organization that sets the standard of excellence in the treatment of specialty behavioral health and addiction disorders.

Acadia’s management style and philosophy is one of collaboration and flexibility as we create an energetic and team-oriented service delivery system. Our organization values input from employees, physicians, and all strategic alliances. As evidenced in our mission statement, Acadia Healthcare’s mission is to create behavioral health centers where people receive care that enables them to regain hope in a supportive, caring environment. We want Acadia to be synonymous with excellent care, phenomenal customer service and an unparalleled commitment to our patients, staff, physicians, and community.

As a leading provider of behavioral healthcare services in the United States and Puerto Rico, Acadia Healthcare operates 253 treatment facilities across 39 states. Our network of treatment facilities offers multiple levels of care for various behavioral health and substance use disorders. At Acadia, our primary goal is to meet patients where they’re at in their treatment process. We do this by providing a multitude of levels of care, including detoxification, residential treatment for addiction, residential treatment for dual diagnosis, acute psychiatric inpatient hospitalization, medication-assisted treatment (MAT) services, and an array of outpatient programming options, ranging from partial hospitalization programs (PHPs) and intensive outpatient programs (IOPs) to traditional outpatient services. Our network of treatment facilities creates greater access to care, reduces the stigma associated with mental illness and addiction, and offers those in our communities a safe environment in which to receive the treatment they need.

Industry: Mental Health Care
Company Size: 10,001+ employees

Acadia Healthcare

Sabal Palms is a substance use treatment center located in Brooksville, Florida. We are looking to hire a full-time Utilization Review Specialist. Sabal Palms offers competitive wages, a comprehensive benefits package, and generous paid time off!

Are you prepared for the impact you can make in your UR career at a well-respected treatment center in Brooksville, Florida? If so, you may enjoy working at Sabal Palms Recovery Center, an addiction treatment facility nestled on a 10-acre campus located along Florida's Nature Coast and surrounded by live oak trees. Sabal Palms Recovery Center provides premier residential treatment for adults aged 18 and older who are struggling with addictions.

Our skilled professionals are focused on sharing their knowledge and expertise to help you get acclimated to your new role. Along with detailed training and continual support, our staff will give you the autonomy you need to achieve your career goals. You will love working to make a difference in the lives of our patients as you collaborate with other professionals and a supportive management team.

We are looking to for a Full Time Utilization Review Specialist to join our team. The UR specialist proactively monitors utilization of services for patients to optimize reimbursement for the facility. This is a Monday-Friday, day position working 40 hours per week.

**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**

- High School diploma or equivalent required.

- Two or more years' experience with the population of the facility and previous experience in utilization management preferred.

**Licenses/Designations/Certifications**

- CPR and de-escalation/restraint certification required (training available upon hire and offered by facility).

- First aid may be required based on state or facility.

**Benefits**

- Medical, Dental, and Vision Insurance

- HSA & FSA

- Company Paid Basic Life & AD&D

- Disability

- 401(k) Retirement Plan - with company match

- Employee Assistance Program/Employee Discount Program

- Paid Holidays

- Paid Time Off

- Tuition Reimbursement

Equal Opportunity Employer

This employer is required to notify all applicants of their rights pursuant to federal employment laws. For further information, please review the Know Your Rights notice from the Department of Labor. null

UR Specialist

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