Insurance Utilization Reviewer Jobs in Washington, DC

The Psychiatric Institute of Washington is a152-bed facility with inpatient, outpatient and partial hospitalization programs. Excellence in behavioral health programs for children, adolescents and adults has been the mission of The Psychiatric Institute of Washington since it opened nearly 50 years ago. As the first and only free standing psychiatric care facilities in Washington, DC, our team has a reputation for providing innovative treatment and care. We strive for excellence, never losing sight of providing patients with hope – hope that although their stay is relatively brief, they may find their way to a brighter future.

ESSENTIAL DUTIES AND RESPONSIBILITIES:

• Tracks new admissions or transfers to assigned area and is responsible for knowing and following through with certification requirements from admission through discharge. Serves as liaison to on-site external reviewers.
• Uses Midas for recording reviews and tracking denials. Adds to Midas databases as needed.
• Teaches staff to document medical necessity through in-services or individual meetings. Monitors quality of records and notifies staff and program director of problems. Available to program director to develop plan for improvement as needed.
• Supports and guides treatment planning as needed. Continues to bring to staff awareness the need for documentation to flow from and correlate with treatment plan.
• Informs department director of changes in managed care companies. Maintains awareness of unique status to propose out of plan benefits or to open the door to increase hospital’s opportunity to provide services to a larger group.
• Works appropriately and professionally with all staff and demonstrates a supportive attitude toward the goals of the hospital. Makes recommendations for the hospital based on identified trends. 
• Arranges schedule in consideration of needs of the department, participates in arranging coverage for planned absences and demonstrates a supportive attitude toward the goals of the department.
• Performs other job related duties as assigned.

Benefit Highlights:

Our employees are our most valuable asset and we are dedicated to provide a challenging and rewarding work environment to all our employees. 

• Generous Paid Time Off 
• Excellent Medical, Dental, Vision and Prescription Drug Plans
• 401(K) with company match and discounted stock plan
• UHS employee discounted stock option plan
• Tuition Reimbursement and Student Loan Repay Program
• Employee Assistant Program (EAP)
• Life Insurance and Disability Insurances
• Flexible Spending Account
• Pre-tax Metro SmartTrip Benefits 
• Career development opportunities within UHS and its 300+ Subsidiaries!

Who we are:  

One of the nation’s largest and most respected providers of hospital and healthcare services, Universal Health Services, Inc. has built an impressive record of achievement and performance. Growing steadily since its inception into an esteemed Fortune 500 corporation, annual revenues were $11.6 billion in 2020. In 2021, UHS was again recognized as one of the World’s Most Admired Companies by Fortune; in 2020, ranked #281 on the Fortune 500; and listed #330 in Forbes ranking of U.S.’ Largest Public Companies. Headquartered in King of Prussia, PA, UHS has 89,000 employees and through its subsidiaries operates 26 acute care hospitals, 334 behavioral health facilities, 39 outpatient facilities and ambulatory care access points, an insurance offering, a physician network and various related services located in 38 U.S. states, Washington, D.C., Puerto Rico and the United Kingdom.

• Bachelor’s degree in applicable field of study required 
• Six months psychiatric utilization review either for hospital or external review organization preferred.
• Candidates must meet the company’s hiring criteria to include a pre-employment verifications, background investigation and drug test.

COVID Requirements
PIW requires its staff to be fully vaccinated against COVID-19 (including any booster shots if required), where allowable under the law, unless they are approved for a reasonable accommodation based on disability, medical condition, or religious belief that prevents them from being vaccinated.

E-VERIFY Statement

PIW participates in E-Verify. We will provide the Social Security Administration, and if necessary, the Department of Homeland Security, with information from each new employee’s Form I-9 to confirm work authorization. Please note that we do not use this information to pre-screen job applicants.

EEO Statement

All UHS subsidiaries are committed to providing an environment of mutual respect where equal employment opportunities are available to all applicants and teammates. UHS subsidiaries are equal opportunity employers and as such, openly support and fully commit to recruitment, selection, placement, promotion and compensation of individuals without regard to race, color, religion, age, sex (including pregnancy, gender identity, and sexual orientation), genetic information, national origin, disability status, protected veteran status or any other characteristic protected by federal, state or local laws.

We believe that diversity and inclusion among our teammates is critical to our success.

Notice

At UHS and all our subsidiaries, our Human Resources departments and recruiters are here to help prospective candidates by matching skillset and experience with the best possible career path at UHS and our subsidiaries. We take pride in creating a highly efficient and best in class candidate experience. During the recruitment process, no recruiter or employee will request financial or personal information (Social Security Number, credit card or bank information, etc.) from you via email. The recruiters will not email you from a public webmail client like Hotmail, Gmail, Yahoo Mail, etc. If you are suspicious of a job posting or job-related email mentioning UHS or its subsidiaries, let us know by contacting us at: https://uhs.alertline.com or 1-800-852- 3449.

• Bachelor’s degree in applicable field of study required 
• Six months psychiatric utilization review either for hospital or external review organization preferred.
• Candidates must meet the company’s hiring criteria to include a pre-employment verifications, background investigation and drug test.

COVID Requirements
PIW requires its staff to be fully vaccinated against COVID-19 (including any booster shots if required), where allowable under the law, unless they are approved for a reasonable accommodation based on disability, medical condition, or religious belief that prevents them from being vaccinated.

E-VERIFY Statement

PIW participates in E-Verify. We will provide the Social Security Administration, and if necessary, the Department of Homeland Security, with information from each new employee’s Form I-9 to confirm work authorization. Please note that we do not use this information to pre-screen job applicants.

EEO Statement

All UHS subsidiaries are committed to providing an environment of mutual respect where equal employment opportunities are available to all applicants and teammates. UHS subsidiaries are equal opportunity employers and as such, openly support and fully commit to recruitment, selection, placement, promotion and compensation of individuals without regard to race, color, religion, age, sex (including pregnancy, gender identity, and sexual orientation), genetic information, national origin, disability status, protected veteran status or any other characteristic protected by federal, state or local laws.

We believe that diversity and inclusion among our teammates is critical to our success.

Notice

At UHS and all our subsidiaries, our Human Resources departments and recruiters are here to help prospective candidates by matching skillset and experience with the best possible career path at UHS and our subsidiaries. We take pride in creating a highly efficient and best in class candidate experience. During the recruitment process, no recruiter or employee will request financial or personal information (Social Security Number, credit card or bank information, etc.) from you via email. The recruiters will not email you from a public webmail client like Hotmail, Gmail, Yahoo Mail, etc. If you are suspicious of a job posting or job-related email mentioning UHS or its subsidiaries, let us know by contacting us at: https://uhs.alertline.com or 1-800-852- 3449.