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Very Experienced Utilization Review (must be LPN or RN) - new facility

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Benefits Offered

Medical, 401K, Life, Vision, Dental

Employment Type

Other

Townsend is growing, and an experienced Utilization Review Nurse is needed for our beautiful, new, soon-to-be open facility in east New Orleans! If you have worked directly with private insurance companies to obtain pre-certifications, then we have a career waiting for you! Townsend is an industry leader in providing addiction treatment to adult patients throughout Louisiana, and Townsend is part of American Addiction Centers, which provides outstanding benefits for full time employees - and even partial benefits for part time employees!

Great benefits and perks include:

1. 100% company-paid health insurance with a low deductible and low co-pays;

2. Opportunity to add spouse and dependents to your insurance;

3. Vision and dental insurance for you and your family;

4. $50,000 life insurance that is 100% company-paid (with the option to purchase more for you and/or your family);

5. Generous vacation/sick (starting at 22 days of Paid Time Off per year & goes up to 31 days per year after your 4th year);

6. $1,000 per employee per 12 months for Continuing Education reimbursement;

7. Many free trainings & opportunities for professional growth & development;

8. Retirement plan – a 401K with partial company match and 100% company vesting at 3 years;

9. Many supplemental insurance plans like accident, critical illness, identify theft, more;

10. Opportunity to purchase stock in the company at a special employee-only rate;

11. Unlimited employee referral bonuses;

12. Great working environment and the opportunity to grow!

Additional information is available at careers.americanaddictioncenters.org or townsendla.com/careers

Email your resume, cover letter and hourly pay rate or salary expectations to TownsendJobs@ContactAAC.com TODAY for immediate, confidential consideration. Write “UTILIZATION REVIEW NURSE FOR NEW FACILITY” in the subject line.

You must have the following credentials, skills and experience for this position:

  • Must have at least TWO (2) years of experience specifically working in Utilization Review as your main job duty – this experience must be clearly described on your resume for you to be considered.

  • Must have very specific, identifiable experience working directly with insurance companies/payors to obtain benefit information as it relates to services provided.

  • Must have very specific, identifiable experience being the sole employee responsible for communicating directly with the insurance companies/payors to maximize opportunities for authorization of services for patients.

  • Must have significant knowledge and strong use of all aspects of Utilization Review including but not limited to medical terminology, Medical Records and Coding, Interqual criteria, ICD-9/ICD-10 (when applicable), CPT Codes and HCPCS codes.

  • Willingness / ability to provide patient care if the UR workload is light and/or nursing team has an emergency staffing shortage.

  • Graduate of an accredited school of nursing.

  • Current licensure in good standing in Louisiana.

  • Prior nursing experience, preferably in behavioral health or addiction treatment

  • Great computer skills including solid understanding of how to use email programs, Word, Excel, etc.

  • Able to effectively communicate both in writing and verbally.

  • Able to positively interact and develop rapport with clients and their families, professional support staff, team members and various levels of staff from the community agencies.

  • Able to act as a role model, demonstrating appropriate problem-solving skills and stress-management skills.

  • Possess an understanding of the role of 12-step principles in sobriety.

  • Willingness to provide excellent customer service.

  • If in recovery, must have 2 years of sobriety.

  • Local candidates only (no relocation)

If you join Townsend, you’ll enjoy the following responsibilities:

  • Pre-certifying new admission insurance clients with insurance companies.

  • Completing concurrent reviews for caseload to extend clients’ length of stay.

  • Sending daily census data to clinical team and uploading for billing team.

  • Communicating authorizations to clinical team to inform what level of care has been authorized for clients.

  • Communicating with the insurance department if a client does not have coverage or there are limitations on client’s policy that becomes available as case is opened with insurance company.

  • Working with clinical and client care team to communicate insurance case manager’s request for specific treatment, follow ups, and individualized care.

  • Ensuring clinical information is available, and if not, following up to ensure information is available.

  • Other duties as assigned.

About Townsend:

Townsend is the leader in the field of addiction treatment in Louisiana, using the most innovative treatment models and genetic research to help thousands of individuals achieve recovery. At Townsend, we understand that addiction is a chronic, progressive brain-based disease that is typically self-medicated with alcohol, drugs, gambling, compulsive overeating, and other substances or behaviors. Thus, even if the substance use and behaviors stop, the primary symptoms of addiction will still be present. Currently there is no cure for addiction, but there is hope at Townsend. Our treatment centers are focused on achieving remission of symptoms which will stop a person from seeking drugs or engaging in other behaviors to feel better.

All Jobs at Townsend http://townsendla.com

Posted 3 days ago

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