| Location | Cleveland, OK |
Job Posting Title
Utilization Review Specialist
Agency
452 MENTAL HEALTH AND SUBSTANCE ABUSE SERV.
Supervisory Organization
GMH - Utilization Review
Job Posting End Date
Refer to the date listed at the top of this posting, if available. Continuous if date is blank.
Note: Applications will be accepted until 11:59 PM on the day prior to the posting end date above.
Estimated Appointment End Date (Continuous if Blank)
Full/Part-Time
Full time
Job Type
Regular
Compensation
Job Description
About the Position:
The Utilization Review (UR) Specialist supports the facility's utilization management processes. Responsibilities include preparing documentation for pre-certification of admissions and continued stays, serving as a liaison with gatekeepers, HMOs, OHCA, and insurance providers, and maintaining daily logs and tracking spreadsheets.
The UR Specialist collects and analyzes data related to medical record documentation compliance, inappropriate admissions, delays in services and discharges, premature discharges, effectiveness of discharge planning, and the over- or under-utilization of resources. The role may also involve coordinating patient transfers when appropriate.
In addition, this position contributes to quality improvement initiatives and ensures compliance with JCAHO, Title XIX, and other regulatory standards. The UR Specialist collaborates closely with the Director of Operations, as well as medical, clinical, and reimbursement staff, to minimize potential loss of revenue.
The UR Specialist participates in interdisciplinary treatment teams, clinical management meetings, and agency meetings, and performs other duties as assigned. This is an on-site position that requires direct patient interaction.
Job Type/Salary:
Minimum Qualifications and Experience:
Special Requirements:
Why Join Us?
About us:
Griffin Memorial Hospital (GMH) is located in Norman, Oklahoma, and serves all 77 counties in Oklahoma as a Department of Mental Health and Substance Abuse Services (ODMHSAS) treatment center for adults. Griffin Memorial Hospital is a 120-bed acute psychiatric hospital serving persons aged 18 and over with severe mental illness and provides in-patient hospital care for those in need of mental health & substance abuse services.
Drug and Alcohol Pre-employment and Preplacement Testing: Upon a conditional offer of employment, applicants for safety sensitive positions shall be required to submit to urinalysis to test for drugs. Appointment to a safety sensitive position shall be contingent upon a negative drug test result.
THIS AGENCY REQUIRES COVERAGE 24 HOURS, 7 DAYS PER WEEK. WORK HOURS AND LOCATION MAY VARY DEPENDING ON BUSINESS NECESSITY. EMPLOYEES MAY BE REQUIRED TO WORK WEEKENDS AND OVERTIME.
Reasonable accommodation to individuals with disabilities may be provided upon request.
An Equal Opportunity Employer.
Equal Opportunity Employment
The State of Oklahoma is an equal opportunity employer and does not discriminate on the basis of genetic information, race, religion, color, sex, age, national origin, or disability.
Current active State of Oklahoma employees must apply for open positions internally through the Workday Jobs Hub.
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