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Overnight Weekend Utilization Review Jobs in California

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Overnight Weekend Utilization Review information

What is the difference between Overnight Weekend Utilization Review vs Overnight Weekday Utilization Review?

AspectOvernight Weekend Utilization ReviewOvernight Weekday Utilization Review
Work SchedulePrimarily performed on weekends, often overnight shiftsPrimarily performed on weekdays, often overnight shifts
CertificationsTypically requires medical or healthcare utilization review certificationsTypically requires medical or healthcare utilization review certifications
Work EnvironmentHealthcare facilities, insurance companies, or third-party review organizationsHealthcare facilities, insurance companies, or third-party review organizations
PurposeReview patient cases and utilization during weekend hours to ensure appropriate care and billingReview patient cases and utilization during weekday hours for similar purposes

Both roles involve reviewing healthcare utilization, requiring similar certifications and working in comparable environments. The main difference lies in the work schedule, with weekend reviews focusing on weekend cases and weekday reviews on weekday cases. Both are essential for continuous healthcare oversight and billing accuracy.

What are the most commonly searched types of Weekend Utilization Review jobs in California?

The most popular types of Weekend Utilization Review jobs in California are:

What cities in California are hiring for Overnight Weekend Utilization Review jobs?

Cities in California with the most Overnight Weekend Utilization Review job openings:

Overnight Weekend Utilization Review jobs near you

Utilization Specialist - Full Time

Acadia Healthcare

Scotts Valley, CA • On-site

$25 - $27/hr

Full-time

Medical, Dental, Vision, Retirement

Re-posted 21 days ago

Acadia Healthcare rating

6.2

Company rating: 6.2 out of 10

Based on 190 frontline employees who took The Breakroom Quiz

698th of 893 rated healthcare providers

Job description

Overview
Utilization Specialist Opportunity (8hours shifts) at The Camp Recovery Center - Scotts Valley, CA
Pay Range$25.00 - $27.00:
We are hiring a compassionate and experienced Utilization Specialist to work with our clients at The Camp Recovery Center in Scotts Valley! This is a key role whose primary goal is to provide a safe, nurturing environment for our adult clients who have co-occurring disorders (substance use disorder and mental health disorders). The Camp is a 74-bed treatment center providing services to adults on both an inpatient and outpatient basis.
Medi-Cal Experience and Understanding Preferred
Responsibilities
ESSENTIAL FUNCTIONS:
  • Act as liaison between managed care organizations and the facility professional clinical staff.
  • Conduct reviews, in accordance with certification requirements, of insurance plans or other managed care organizations (MCOs) and coordinate the flow of communication concerning reimbursement requirements.
  • Monitor patient length of stay and extensions and inform clinical and medical staff on issues that may impact length of stay.
  • Gather and develop statistical and narrative information to report on utilization, non-certified days (including identified causes and appeal information), discharges and quality of services, as required by the facility leadership or corporate office.
  • Conduct quality reviews for medical necessity and services provided.
  • Facilitate peer review calls between facility and external organizations.
  • Initiate and complete the formal appeal process for denied admissions or continued stay.
  • Assist the admissions department with pre-certifications of care.
  • Provide ongoing support and training for staff on documentation or charting requirements, continued stay criteria and medical necessity updates.

OTHER FUNCTIONS:
  • Perform other functions and tasks as assigned.

Qualifications
EDUCATION/EXPERIENCE/SKILL REQUIREMENTS:
  • Required Education: High school diploma or equivalent.
  • Preferred Education: Associate's, Bachelor's, or Master's degree in Social Work, Behavioral or Mental Health, Nursing, or a related health field.
  • Experience: Clinical experience is required, or two or more years' experience working with the facility's population. Previous experience in utilization management is preferred
  • UM Experience preferred
  • Medi-Cal experience and understanding preferred

LICENSES/DESIGNATIONS/CERTIFICATIONS:
  • Preferred Licensure: LPN, RN, LMSW, LCSW, LPC, LPC-I within the state where the facility provides services; or current clinical professional license or certification, as required, within the state where the facility provides services.
  • CPR and de-escalation and restraint certification required (training available upon hire and offered by facility.
  • First aid may be required based on state or facility requirements.

COMPENSATION:
Compensation for roles at THE CAMP RECOVERY CENTER varies depending on a wide array of factors including but not limited to the specific location, role, skill set, and level of experience. As required by local law, THE CAMP RECOVERY CENTER provides a reasonable hourly range of compensation for roles that may be hired in California as set forth below.
Role Location: CALIFORNIA
Calculated Hourly Range for role Utilization Specialist
State - California: $25.00 - $27.00
BENEFITS: For Full Time Staff only
The Camp Recovery Center provides a comprehensive package of benefits for our Full Time Utilization Specialist.. Current benefits include:
  • Competitive hourly rate
  • Shift differential for overnight shifts
  • Medical, dental, and vision insurance
  • Acadia Healthcare 401(k) plan
  • Excellent training program
  • Complimentary AOD Education to certify as a Substance Use Disorder Counselor
  • Professional growth opportunity that is second to none in the industry.

AVAILABLE SHIFTS AND HOURS:
This is a Full-Time EMT position Monday - Friday . Shifts are 8 - hours, and are overtime eligible
ADDITIONAL REGULATORY REQUIREMENTS:
As Needed
While this job description is intended to be an accurate reflection of the requirements of the job, management reserves the right to add or remove duties from particular jobs when circumstances
(e.g. emergencies, changes in workload, rush jobs or technological developments) dictate.
We are committed to providing equal employment opportunities to all applicants for employment regardless of an individual's characteristics protected by applicable state, federal and local laws.

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About Acadia Healthcare

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Acadia Healthcare is a leading provider in the healthcare and hospital industry, based in Franklin, Tennessee, United States. The company is recognised for its commitment to creating a behavioural health network that provides accessible, high-quality treatment options for individuals suffering from mental health issues, addiction, eating disorders, and PTSD. Acadia Healthcare was founded in 2005, with the mission to create a world-class organization that sets the standard of excellence in the treatment of specialty behavioural health and addiction disorders.

Industry

Hospitals

Company size

10,000+ Employees

Headquarters location

Franklin, TN, US

Year founded

2005

Social media

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