UR Case Manager

Description

Are you interested in working in a fast-paced, challenging behavioral healthcare organization? Are you interested in a position that is rewarding and makes a difference in the lives of others? Do you like to be challenged and work in a setting that allows you to grow? Then Alvarado Parkway Institute wants to hear from you! 

Requirements

UR Case Manager Responsibilities:

• Conducts concurrent and extended stay reviews
• Prepares and submits appeals to 3rd party payers.
• Maintains appropriate records of the Utilization Review Department.
• Participates in activities which enhance professional growth and development.
• Other duties as assigned.

Required Skills and Experience:

• High school, - preferably college -, level reading, writing, and math skills
• Excellent telephone usage skills and strong verbal skills
• Knowledge of health care service delivery systems and third-party reimbursement
• Understanding of admission and discharge function
• Familiarity with medical terminology, diagnostic terms and treatment modalities
• Knowledge of medical record keeping
• Strong interpersonal, organizational, evaluative, and time management skills
• Policy interpretation skills
• Familiarity with applicable standards and regulations
• Able to comprehend psychiatric evaluations, consults, lab results, etc.
• Flexibility 
• Attention to detail
• Responsiveness to deadlines
• Assertiveness, persistence, and persuasiveness
• Able to work with minimal direction or supervision

Required Education:

• Graduate of accredited RN/LVN program and current RN/LVN license or Master’s level training in a behavioral health field.

Preferred Education, Experience, and Certifications:

• Experience in psychiatric field preferred.

Physical Requirements:

• Use standard office equipment and access, input, and retrieve information from a computer.
• Use computer keyboard with manual and finger dexterity and wrist-finger speed sufficient to perform repetitive actions efficiently for extended periods of time.
• Communicate effectively in person or via telephone in a manner which can be understood by those with whom the person is speaking, including a diverse population.
• Give and follow verbal and written instructions with attention to detail and accuracy.
• Perform complex mental functions and basic arithmetic functions; interpret complex laws, regulations, and policies; collect, interpret, and/or analyze complex data and information.
• Vision sees details of objects at close range.
• Coordinate multiple tasks simultaneously.
• Reach forward, up, down, and to the side.
• Sit or stand for minimum periods of one hour at a time and come and go from the work area repeatedly throughout the day.
• Walk and/or stand for long periods of time (3/4 of the workday). 
• Lift up to fifteen (15) pounds.

Conditions of Employment

In compliance with API’s policies and guidelines, all API employees are required to adhere to the following:

• Completion of a satisfactory background and reference checks.
• Employee signed employment non-compete/confidentiality agreement
• Individuals whose position may require licensure, registration or certification must maintain such as current and valid. It is the employee's responsibility to send updated copies to Human Resources before the expiration date. It is the employee's responsibility to notify Human Resources of any changes or proposed changes in status to licensure, registration, or certification. Failure to do so could result in employee suspension.

• Provide a copy of COVID-19 Vaccination OR have an Exemption Request (Deferred Pregnancy, Medical, or Religious) approved by the API HR Director; and those who have an approved Exemption must undergo weekly COVID-19 testing and observe all other infection control requirements, including face coverings.
• Annual Flu vaccination is required as a condition of hire and ongoing employment. Only those who are allergic to the vaccine or meet contraindications as indicated on the current CDC Vaccine Information Statement shall be exempt from this condition of hire and ongoing employment but are required to wear a mask while inside an API owned or operated building or vehicle during influenza season, Employees must provide physician documentation to support any reported allergy or contraindication. Flu season typically runs between November and March.
• Pass drug and alcohol test performed by Concentra.
• Clear TB skin test or Chest X-Ray at Concentra.
• Complete a satisfactory physical examination at Concentra designed solely to determine your ability to perform the duties of the position being offered. 

API provides equal employment opportunities to all employees and applicants for employment and prohibits discrimination and harassment of any type without regard to race, color, religion, age, sex, national origin, disability status, genetics, protected veteran status, sexual orientation, gender identity or expression, or any other characteristic protected by federal, state or local laws.