UR Supervisor

Responsibilities: 

• Exhibit timeliness, patience, confidence, and accountability, to all departments, both internal and external.Provide service support and training to the team in addition to initiating and implementing process improvements.

• Assign cases to UR Reps/UR appeals specialist forinitialauthorizations/coverage cases.Determinesmedical necessity, level of care and appropriateness of services using clinical review criteria-based information given by providers.
• Be available and flexible with weekends and holidays for support and guidance to the team.
• Coordinate department activities: staff education, policy and procedure development and revision. Liaison with day-to-day productivity and communication needs amongst all departments (Admission, clinical, medical,etc)
• Co coordinate staff meetings with UR manager,facilitatemeetings as needed. 
• Participate in the development and implementation of department/division projects.
• Maintain the role of UR specialist with a reduced caseload for SUD and MH. 
• Communicates necessary information with management and billing to ensure a seamless revenue cycle, along with all UR specialists and otherdepartmentsas necessary.
• Maintains up to date knowledge of insurance payer requirements.
• Keep current andaccuratedocumentation in Salesforce and EMR systems as well as ensuringaccuratedocumentation and management of information from UR specialists.
  • Other duties as assigned include and are not limited to.
  • Providing admissions with guidanceon Authorizations for a potential client and any risks of admission to specific levels of care.
  • Knowledge of Federal policies specifications for all facility states and future facilities
  • Assistmanager with creating andmaintaininga positive work culture and growth. 

Preferred Qualifications: 

• Bachelor’s degree in psychology, Mental HealthCounseling, SocialWorkoranotherrelated field. 

• Experience with clinical decision-making criteria sets (i.e.Milliman, InterQual) 

Minimum Qualifications: 

• Five (5) years’ experience in chart analysis and utilization review in the psychiatric and chemical dependency field preferred.

• Exceptional oral and written communication skills required to communicate in a clear and concise manner with patients, physicians, staff, and administration along with the ability to positively influence others with respect and compassion.
• The ability to manage emotions and impulses and present calmly while working in a fast-paced environment with frequent interruptions.
• Strong work ethic built on a foundation of proactivity and teamwork.
• Ability to navigate ambiguity with the aid of structured problem-solving techniques.
• Computerproficiencyin Microsoft Office

Physical Requirements: 

• During remote work, employee is responsible for ergonomic requirements and a work area free from distractions.

• Role is performed usingcomputer(including screen, keyboard, mouse,etc),phone,and other typical office equipment.
• Significant phone workincludingtalking and listening.
• Note:Reasonable accommodations may be made to enable individuals with disabilities to perform the essential functions.

Benefits:

• 401(k)
• 401(k) matching
• Dental insurance
• Disability insurance
• Employee assistance program
• Flexible spending account
• Health insurance
• Health savings account
• Life insurance
• Paid time off
• Referral program
• Vision insurance

Work Location: Remote