Utilization Review Technician conducts utilization reviews to determine if patients are receiving care appropriate to illness or condition. Monitors patient charts and records to evaluate care concurrent with the patients treatment. Being a Utilization Review Technician reviews treatment plans and status of approvals from insurers. Collects and complies data as required and according to applicable policies and regulations. Additionally, Utilization Review Technician consults with nurses and physicians as needed. Position is non-RN. May require an associate degree or its equivalent. Typically reports to a supervisor. May require Registered Health Information Technician (RHIT). The Utilization Review Technician gains exposure to some of the complex tasks within the job function. Occasionally directed in several aspects of the work. To be a Utilization Review Technician typically requires 2 to 4 years of related experience. (Copyright 2024 Salary.com)
Windmill Wellness opened the Ranch in May of 2017. We are nestled in the Texas Hill Country and are sitting on 76 acres. The mission of Windmill Wellness Ranch Is to improve the physical, spiritual and emotional health of the individual and their family through and integrated healing system using the latest technology and research. Windmill Wellness Ranch is a co-occurring inpatient and outpatient treatment center specializing in trauma therapies, substance use disorders and mental health. WWR has the highest outcomes in the nation, as measured by a third-party scientific firm, Trac9.
WWR has been recognized as one of the top workplaces by the San Antonio Express News.
Qualifications:
The Utilization Management Specialist will determine if authorization is necessary for the services that are needed and obtain such authorization for behavioral health services on an on-going basis. Conducts utilization reviews to determine if patients are receiving care appropriate to illness or condition. Audits medical record data to ensure compliance and justify treatment or length of stay. Reports and maintains documentation regarding patient continued treatment, stay or care.
Job Type: Full-time
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Work Location: In person