Outpatient Clinician w/ UR Function
UHS
Summary
Heritage Oaks Hospital is seeking a dedicated Clinician (With UR Function) for our Outpatient department. The clinician provides quality psychotherapeutic and case management services to all patients and their families, serving as a member of an interdisciplinary team supporting the organization's outpatient treatment program and philosophy.
Job description
Key Responsibilities
- Facilitation of group therapy under the supervision of a licensed therapist
- Case management services including treatment planning and participation in multidisciplinary treatment team
- Crisis intervention
- Discharge planning
- Coordination of care with follow-up providers and identified support person(s)
- Provide support to team members as needed
Utilization Review Responsibilities
- Managing, reviewing and monitoring the utilization of resources related to the patient to maximize effectiveness of care by evaluating clinical appropriateness
- Function as liaison between payors, the business office, and treatment team, providing information and feedback to assist in optimum patient care and reimbursement
- Review with payor sources and receive authorization for the type and volume of services through all levels of care and aftercare review
- Formulate and conduct educational, therapeutic, and/or support groups as needed
- Assess and identify psychosocial, educational, developmental and behavioral functioning of the patient/family system through established case finding mechanisms
- Participate in and contribute to patient care conferences, treatment planning meetings and/or treatment planning rounds
- Work cooperatively with Assessment & Referral in establishing clinical pre-authorization
- Communicate with the business office regarding information pertaining to insurance benefits and coverage
- Attend treatment planning meetings and oversee coordination of care for patients with respect to available financial resources, including notifying attending physician/treatment team of actual or potential denial
Schedule: Monday - Friday / 8 AM - 4:30 PM
Requirements
- Master's degree in social work, mental health or a related field required
- Minimum of one (1) year experience with communication with external review organizations or comparable entities, or four (4) years direct clinical experience in a psychiatric or mental health setting
- Must be registered with the California Board of Behavioral Sciences (ACSW, AMFT, APCC)
- Trained in Handle with Care (HWC) within the first 30 days of employment
- CPR certification required
- Prior experience with prior authorizations or Case Management is preferred
Benefits
- Medical, Dental & Vision
- Prescription Drug Plan
- Paid Time Off
- 401(k) Matching
- Discounted Stock Plan
- Career Development
- Education Assistance
Company overview
Universal Health Services, Inc. (UHS) is one of the nation's largest and most respected providers of hospital and healthcare services, operating as a Fortune 300 corporation headquartered in King of Prussia, Pennsylvania. Founded in 1979, UHS has grown into a major healthcare enterprise with approximately 99,000 employees and annual revenues exceeding $14 billion. The company operates through its subsidiaries, managing 29 acute care hospitals, 331 behavioral health facilities, and 60 outpatient and other facilities across 39 U.S. states, Washington D.C., Puerto Rico, and the United Kingdom. UHS provides comprehensive healthcare services including acute care, behavioral health treatment, cancer centers, and ambulatory surgical centers. The company's strategy focuses on building or acquiring high-quality hospitals in rapidly growing markets and investing in advanced medical equipment and skilled personnel to become the leading healthcare provider in each community it serves. UHS is publicly traded on the New York Stock Exchange (NYSE: UHS) and has established a strong reputation for delivering compassionate, high-quality care while maintaining financial stability and operational excellence.