Job: UR (Utilization Review)

Rosewood Centers for Eating Disorders in Wickenburg, Arizona is expanding with their newly opened 24 bed adult inpatient facility, and new 14 bed adolescent program. Rosewood’s success for over a decade is based on their ability to treat severe eating disorders with an intensive, medically sophisticated, cutting-edge, interdisciplinary program. Rosewood is located on a serene 14 acre campus in the beautiful Sonora desert, just 60 miles northwest of Phoenix, AZ. Rosewood is JCAHO accredited and is the only ED treatment center for adult/adolescent men and women in AZ that accepts insurances.
Works with patient, financial office, physician and insurance companies to facilitate admission and continued stay in the facility. Utilizes knowledge of medical and psychiatric diagnoses, APA guidelines and DSM lV guidelines. Utilizes knowledge of managed care process including pre-certification and con-current review. Performs review of facility documentation. Attends treatment-planning session for clients with current open cases. Works in conjunction with business office to provide patient with financial information relating to admission.

ESSENTIAL DUTIES AND RESPONSIBILITIES
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1. Review patient documents for medical necessity.

2. Performs review with insurance company and provides written summaries as required by insurance companies.

3. Facilitates dissemination of information as required by insurance company, providers and staff.

4. Coordinates reviews with Medical Director as necessary.

5. Communicates information to financial office and staff.

6. Coordinates appeals process to insurance company for denials as well as written appeals.

7. Perform all UR for Capri campus and Tempe IOP

8. Provide UR back up for Rosewood inpatient as needed.

9. Perform weekly and monthly chart audits. Report all findings to the Director of Business Development.

10. Attends staffing for clients.

11. Assists with treatment planning as necessary.

12 Other duties as requested.

13. Participates as a team player in Rosewood staff milieu and works harmoniously with all other staff

Master's Degree in behavioral health discipline.

A basic working knowledge of DSM diagnosis, mental status examination and psychiatric medications.

Eating disorder experience is preferred but will train the right candidate.

Excellent verbal communication skills.

Please submit resume online below.