Outpatient Clinician with Utilization Review Function

Responsibilities

Heritage Oaks Hospital is part of the UHS Family of Providers which has been highly regarded as an integral part of the greater Sacramento and Northern California mental health system since 1988. Conveniently located in northern Sacramento, Heritage Oaks is a fully accredited, 125-bed acute psychiatric hospital offering a full range of individually tailored treatment services to adolescents, adults, and senior adults, including treatment for substance abuse and chemical dependency issues with drugs and alcohol. Heritage Oaks is a Medicare provider in addition to contracts with most commercial health insurance plans. We are committed to providing service excellence to all and ensuring our patients receive the optimal level of care that will be most beneficial to their health and recovery.

Website: https://heritageoakshospital.com/

We are 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, to serve as a member of interdisciplinary team supporting the organization's outpatient treatment program and philosophy and assure the deliverance of quality treatment to patients and their families as needed. Key responsibilities include the 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) and provide support to team members as needed.

Additional UR responsibilities: Managing, reviewing and monitoring the utilization of resources related to the patient and to maximize effectiveness of care by evaluating clinical appropriateness. The Utilization Review Clinician functions as liaison between payors, the business office, and treatment team, providing information and feedback to assist in optimum patient care and reimbursement. The Clinician will also 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 effectively contributes to, patient care conferences, treatment planning meetings and/or treatment planning rounds.
• Works cooperatively with Assessment & Referral in establishing clinical pre-authorization.
• Communicates with the business office regarding any information pertaining to insurance benefits and coverage.
• Attend treatment planning meetings and oversee the coordination of care for patients in respect to the available financial resources which includes notifying attending physician/treatment team of  actual or potential denial.

Schedule: Monday - Friday / 8 AM - 4:30 PM

Heritage Oaks offers comprehensive benefits such as:

• Competitive Compensation
• Excellent Medical, Dental, Vision, and Prescription Drug Plan
• Generous Paid Time Off
• 401(K) with company match and discounted stock plan
• Career development opportunities within UHS and its Subsidiaries
• Education Assistance
• Challenging and rewarding work environment

Qualifications

Education: Master’s degree in social work, mental health or a related field required.

Experience: A 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.

Prior experience with prior authorizations or Case Management is preferred. 

Licensure: Must be registered with the California Board of Behavioral Sciences. (ACSW, AMFT, APCC)

Additional Requirements: Trained in Handle with Care (HWC) within the first 30 days of employment. Training provided by HOH. CPR certification required.

About Universal Health Services

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 exceeding $11 billion in 2019. In 2020, UHS was again recognized as one of the World’s Most Admired Companies by Fortune on the Fortune 500; and recognized in Forbes ranking of America’s Top 500 Public Companies. Headquartered in King of Prussia, PA, UHS has over90,000 employees and through its subsidiaries operates 26 acute care hospitals, 328 behavioral health facilities, 42 outpatient facilities and ambulatory care access points, an insurance offering, a physician network and various related services located in 37 U.S. states,

Washington, D.C., Puerto Rico and the United Kingdom.

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.