Utilization Reviewer (Call-in) Details

Utilization Reviewer (Call-in)

Sutter Health - 'Ewa Beach, HI

Employment Type : Full-Time

Position Overview:
Located on 14.5 acre campus, Kahi Mohala's 88-bed facility is Hawaii's only private, freestanding psychiatric hospital and center for psychiatry. Kahi Mohala provides comprehensive behavioral health services for adults, adolescents and children experiencing problems with psychiatric disorders, alcohol and drug abuse, anxiety, depression, eating disorders, emotional disturbances and work of family relationship challenges. Reviews all patients admitted to Kahi Mohala Hospital programs, assures that they meet admitting criteria and continue stay criteria for each level of care. Performs telephonic concurrent reviews with 3rd party payor as needed. Attends all managed care meetings as directed. Assures appropriate documentation to support level of care. Participates as an active team member; performs other duties as assigned.
Qualifications:
Education/Licensure:Graduate of accredited RN program, BSN with managed care experience preferred; current Hawaii RN license required. Experience:Seasoned inpatient psychiatric, managed care / utilization review and quality assurance experience required. Knowledge:Familiarity and clear understanding of regulatory/contractual standards (ie. TJC, Tricare, CAMHD). Knowledge of admission criteria and continued stay criteria for each level of care. Skills:Effective verbal communication, excellent telephone skills/etiquette. Must be computer literate, able to prioritize, delegate and problem solve.
Organization: Kahi Mohala Hospital, Hawaii
Employee Status: Regular
Employee Referral Bonus: No
Benefits: No
Position Status: Non-Exempt
Union: No
Job Shift: Day
Shift Hours: 8 Hour Shift
Days of the Week Scheduled: Varied Days
Weekend Requirements: None
Schedule: Per Diem
Hrs Per 2wk Pay Period: varies