Utilization Review Manager - Home Care jobs in Bakersfield, CA

About Us

Bakersfield Behavioral Healthcare Hospital, located in Bakersfield, California, is an acute psychiatric and behavioral 90 bed facility situated on 8.8 acres.

We offer inpatient and outpatient services for children, adolescents and adults needing mental/behavioral health, chemical dependency; and co-occurring disorders treatment through our medically supervised detoxification.

Within our Workplace Community, BBHH is striving daily to be one of the BEST PLACES TO WORK not just here in Kern County, but throughout the Behavioral Healthcare Community.

By offering amazing benefits, encouraging individual growth and development, and incorporating our CARES values system into our daily operations, we are creating a workplace culture where people enjoy coming to work each day.

BBHH CARES about your experience as a candidate and we encourage you to apply to our open positions.

Compassion

Acceptance
Respect

Empowerment

Sincerity

Our progressive and dedicated healthcare team strives to change the lives of our patients and provide exceptional care.

This is a fast-paced environment that requires critical thinking, exceptional leadership, teamwork, and communication skills.

ESSENTIAL DUTIES

The primary responsibility of the Utilization Review Specialist is to review medical records and prepare clinical appeals (when appropriate) on medical necessity, level of care, length of stay, authorizations and denials for patients. The UR Specialist is responsible for contacting external case managers/managed care organizations for certification and recertification of insurance benefits throughout the patient’s stay, and assists the treatment team in understanding the insurance company’s requirements for continued stay and discharge planning. The UR Specialist is responsible for having a thorough understanding of the patient’s treatment through communication with the treatment team. The UR Specialist advocates for the patient’s access to services during treatment team meetings and through individual physician contact. The UR Specialist chairs treatment team meetings and continued stay reviews as indicated.

wage range: $27.07/hr. - $33.37/hr. based on experience