Utilization Specialist

Job description

Overview ​ PURPOSE STATEMENT: Seven Hills Hospital is a growing, private, 134-bed psychiatric hospital that is dedicated to providing high-quality care for adults, geriatrics, and adolescents (ages 5-17) who are suffering from behavioral health and chemical dependency issues. Our patients recover at our new, state-of-the art medical facility in the Seven Hills area of Henderson, Nevada. Henderson is one of the fastest growing cities in the US and is located just 7 miles from the famed Las Vegas Strip and a couple of miles from beautiful Lake Mead. Seven Hills Hospital is part of the Acadia Healthcare, a provider of behavioral healthcare services throughout the US. ​Proactively monitor utilization of services for patients to optimize reimbursement for the facility. Responsibilities: ​ 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 med...