UR Specialist

Are you prepared for the impact you can make in your career at a well-respected treatment center in Navarre, Florida? If so, you may enjoy working at Twelve Oaks Recovery Center, an addiction and co-occurring mental health treatment facility that provides a full continuum of care for adults.

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.

Twelve Oaks Recovery is looking to hire a full time Utilization Review Specialist. The role of our UR Specialist is to proactively monitor utilization of services for patients to optimize reimbursement for the facility.

If this sounds like the place for you, contact us today. For more information about this opportunity, please call Brenda Maynard, HR Director: 850-939-1200 x203.

RESPONSIBILITIES:

• 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.

BENEFITS:

Twelve Oaks provides a comprehensive package of benefits for all Full-Time and Part-Time Benefit Eligible employees. Current benefits include:

• Competitive hourly rate with shift differential available
• Medical, dental, and vision insurance
• Acadia Healthcare 401(k) plan
• General Paid Time off to include: Vacation, Sick, Personal Days, and Extended Sick Leave
• Excellent training program
• Professional growth opportunity that is second to none in the industry. Join a team with defined career paths and a national family of hospitals and facilities

Equal Opportunity Employer/Protected Veterans/Individuals with Disabilities

The contractor will not discharge or in any other manner discriminate against employees or applicants because they have inquired about, discussed, or disclosed their own pay or the pay of another employee or applicant. However, employees who have access to the compensation information of other employees or applicants as a part of their essential job functions cannot disclose the pay of other employees or applicants to individuals who do not otherwise have access to compensation information, unless the disclosure is (a) in response to a formal complaint or charge, (b) in furtherance of an investigation, proceeding, hearing, or action, including an investigation conducted by the employer, or (c) consistent with the contractor's legal duty to furnish information. 41 CFR 60-1.35(c)