Utilization Manager
samaritanvillage
FULL TIME
Utilization Manager
archildrens· ACH Arkansas Children's Hospital
About this role
ARKANSAS CHILDREN'S IS A TOBACCO FREE WORKPLACE. FLU VACCINES ARE REQUIRED. ARKANSAS CHILDREN'S IS AN EQUAL OPPORTUNITY EMPLOYER. ALL QUALIFIED APPLICANTS WILL RECEIVE CONSIDERATION FOR EMPLOYMENT WITHOUT REGARD TO RACE, COLOR, RELIGION, SEX, SEXUAL ORIENTATION, GENDER IDENTITY OR EXPRESSION, NATIONAL ORIGIN, AGE, DISABILITY, PROTECTED VETERAN STATUS OR ANY OTHER CHARACTERISTIC PROTECTED BY FEDERAL, STATE, OR LOCAL LAWS.
This position has been designated as safety sensitive and cannot be filled by a candidate who is a current user of medical marijuana.CURRENT EMPLOYEES: Please apply via the internal career site by logging into your Workday Account (https://www.myworkday.com/archildrens/)and search the "Find Jobs" report.
Work Shift:
Day ShiftTime Type:
Full timeDepartment:
CC017217 Children's Specialty ServicesSummary:
Arkansas Children's Behavioral Health, FT, M-F, 8a-5pAdditional Information:
The Utilization Manager improves overall quality of clinical documentation to ensure that information in the medical record accurately reflects client's care and progress, and thus utilization of resources. This role works with providers to correctly capture that services being delivered are medically necessary and timely.
RN or LPC Required
Masters Degree Required
3 years in Mental Health/ Hospital Setting
Required Education:
Master's degree in a related field of study.Recommended Education:
Master's degree in a related field of study., Master's Degree NursingRequired Work Experience:
Recommended Work Experience:
Required Certifications:
1 of the following certifications is required -Recommended Certifications:
Licensed Certified Social Worker (LCSW) - Arkansas Professional Board, Licensed Professional Counselor (LPC) - Arkansas Board of Examiners in Counseling, RN License (AR or Compact State) - Arkansas State Board of Nursing (ASBN)Description
1. Complete concurrent and retrospective medical record reviews to ensure services are appropriate, efficient, and compliant with payer and regulatory guidelines.
2. Process pre-authorizations and requests for services that are medically necessary and adherent to payer rules.
3. Consult with multidisciplinary team members regarding patient diagnosis, medical justification, length of treatment, and case documentation.
4. Represents the clinical and administrative team with payers for any appeals or disagreements related to care plans.
5. Provide training and education about utilization requirements to clinical and supervisory staff.
6. Demonstrate competency on mental health symptomology, treatment options and efficacies, and impact of trauma and mental health on overall well-being.
7. Participate in quality or accreditation audits to ensure program compliance on utilization review regulations.
8. Completes clinical supervision and staffing to clinicians completing their required supervision hours for full licensure, if necessary.
9. Knowledge of regulatory requirements and Arkansas laws governing services to children, adolescent and adults preferred.
10. Other duties as assigned.
Frequently Asked Questions
Is the salary disclosed for the Utilization Manager position at archildrens?
The salary for this Utilization Manager role at archildrens is not publicly listed. Click "Apply Now" to learn more about the compensation package on their official careers page.
Where is the Utilization Manager position at archildrens located?
This Utilization Manager role at archildrens is based in Little Rock, Little Rock Paradox. The position is listed as on-site or hybrid. Check the full job description or apply directly to confirm the work arrangement.
Is the Utilization Manager role at archildrens full-time or part-time?
This is listed as a Full time position. It is posted as a Utilization Manager role in the ACH Arkansas Children's Hospital department at archildrens.
Which team or department does the Utilization Manager at archildrens belong to?
This Utilization Manager position is part of the ACH Arkansas Children's Hospital department at archildrens. See the full job description for more information about the team structure and responsibilities.
How do I apply for the Utilization Manager position at archildrens?
Click the "Apply Now" button on this page. You will be redirected to archildrens's official application portal hosted on workday where you can submit your application directly.
Utilization Manager
archildrens
You'll be redirected to archildrens's official application page on Workday.