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Utilization Review Specialist, Behavioral Health Job Opening In Berkeley – Now Hiring Sutter Health

Utilization Review Specialist, Behavioral Health

    United States Jobs Expertini Expertini › United States › Jobs › Berkeley › Other General › Utilization Review Specialist, Behavioral Health

Job description

We are so glad you are interested in joining Sutter Health!

**Organization:**

ABSMC-Alta Bates Herrick Campus

**Position Overview:**

Accumulates, interprets, and documents timely information to justify acute hospital admission, need for continued stay, and proper utilization of physician, nursing, and ancillary services.

Responsible for concurrent review on specific patients.

Develops, coordinates and monitors systems for the appeal/denial process, tracks and trends data, and coordinates utilization management activities for the assigned area.

Collaborates with hospital administration, medical staff, patient registration and representatives of review organizations and others to ensure effective utilization of services and appropriate service reimbursement.

Monitors and acts as a liaison between external payers, internal business office, admissions staff, and clerical unit staff to assure that quality care is delivered at the appropriate level of service and that documentation of care meets appropriate standards.

Interfaces with hospital administration and unit medical doctors and provides data related to the current management of resources.

Adheres to all local/state/federal regulations, codes, policies and procedures to ensure privacy and safety while delivering optimal patient care.

**Job Description** :

_These Principal Accountabilities, Requirements and Qualifications are not exhaustive, but are merely the most descriptive of the current job.

Management reserves the right to revise the job description or require that other tasks be performed when the circumstances of the job change (for example, emergencies, staff changes, workload, or technical development)._

**DEPARTMENT REQUIRED EDUCATION**

+ Department, Behavioral Health: Master’s in Social Work or related field

**SKILLS AND KNOWLEDGE:**

+ Working knowledge of medical terminology, including general knowledge of illnesses, current treatments and their physical and psychosocial sequelae.
+ Knowledge of alternate levels of care including criteria required for payment and applications processes.
+ Ability to interpret a variety of data and instructions, furnished in written, oral, diagram, or schedule form.
+ Possess written and verbal communications skills to communicate with fellow team members, supervisors, patients, and other hospital personnel.
+ Well-developed time management and organizational skills, including the ability to prioritize assignments and work within standardized policies and procedures to achieve objectives and meet deadlines.
+ Demonstrated knowledge of computer applications, such as Crystal Report writing, Midas Plus, Excel, Sunrise, MS Word, PCIS, and InterQual.
+ Work independently, as well as be part of the team, including accomplishing multiple tasks in an environment with interruptions.
+ Identify, evaluate and resolve standard problems by selecting appropriate solutions from established options.
+ Ensure the privacy of each patient’s protected health information (PHI).
+ Build collaborates relationships with peers and other staff members to achieve departmental and corporate objectives.

**Job Shift:**

Days

**Schedule:**

Full Time

**Shift Hours:**

8

**Days of the Week:**

Monday - Friday

**Weekend Requirements:**

As Needed

**Benefits:**

Yes

**Unions:**

No

**Position Status:**

Non-Exempt

**Weekly Hours:**

40

**Employee Status:**

Regular

Sutter Health is an equal opportunity employer EOE/M/F/Disability/Veterans.

Pay Range is $47.67 to $71.51 / hour

_The salary range for this role may vary above or below the posted range as determined by location.

This range has not been adjusted for any specific geographic differential applicable by area where the position may be filled.

Compensation takes into account several factors including but not limited to a candidate’s experience, education, skills, licensure and certifications, department equity, training and organizational needs.

Base pay is just one piece of the total rewards program offered by Sutter Health.

Eligible roles also qualify for a comprehensive benefits package._ _​_

Required Skill Profession

Other General


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Unlock Your Utilization Review Potential: Insight & Career Growth Guide


Real-time Utilization Review Jobs Trends (Graphical Representation)

Explore profound insights with Expertini's real-time, in-depth analysis, showcased through the graph here. Uncover the dynamic job market trends for Utilization Review in Berkeley, United States, highlighting market share and opportunities for professionals in Utilization Review roles.

4356 Jobs in United States
4356
5 Jobs in Berkeley
5
Download Utilization Review Jobs Trends in Berkeley and United States

Are You Looking for Utilization Review Specialist, Behavioral Health Job?

Great news! is currently hiring and seeking a Utilization Review Specialist, Behavioral Health to join their team. Feel free to download the job details.

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The Work Culture

An organization's rules and standards set how people should be treated in the office and how different situations should be handled. The work culture at Sutter Health adheres to the cultural norms as outlined by Expertini.

The fundamental ethical values are:

1. Independence

2. Loyalty

3. Impartiapty

4. Integrity

5. Accountabipty

6. Respect for human rights

7. Obeying United States laws and regulations

What Is the Average Salary Range for Utilization Review Specialist, Behavioral Health Positions?

The average salary range for a varies, but the pay scale is rated "Standard" in Berkeley. Salary levels may vary depending on your industry, experience, and skills. It's essential to research and negotiate effectively. We advise reading the full job specification before proceeding with the application to understand the salary package.

What Are the Key Qualifications for Utilization Review Specialist, Behavioral Health?

Key qualifications for Utilization Review Specialist, Behavioral Health typically include Other General and a list of qualifications and expertise as mentioned in the job specification. The generic skills are mostly outlined by the . Be sure to check the specific job listing for detailed requirements and qualifications.

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Interview Tips for Utilization Review Specialist, Behavioral Health Job Success

Sutter Health interview tips for Utilization Review Specialist, Behavioral Health

Here are some tips to help you prepare for and ace your Utilization Review Specialist, Behavioral Health job interview:

Before the Interview:

Research: Learn about the Sutter Health's mission, values, products, and the specific job requirements and get further information about

Other Openings

Practice: Prepare answers to common interview questions and rehearse using the STAR method (Situation, Task, Action, Result) to showcase your skills and experiences.

Dress Professionally: Choose attire appropriate for the company culture.

Prepare Questions: Show your interest by having thoughtful questions for the interviewer.

Plan Your Commute: Allow ample time to arrive on time and avoid feeling rushed.

During the Interview:

Be Punctual: Arrive on time to demonstrate professionalism and respect.

Make a Great First Impression: Greet the interviewer with a handshake, smile, and eye contact.

Confidence and Enthusiasm: Project a positive attitude and show your genuine interest in the opportunity.

Answer Thoughtfully: Listen carefully, take a moment to formulate clear and concise responses. Highlight relevant skills and experiences using the STAR method.

Ask Prepared Questions: Demonstrate curiosity and engagement with the role and company.

Follow Up: Send a thank-you email to the interviewer within 24 hours.

Additional Tips:

Be Yourself: Let your personality shine through while maintaining professionalism.

Be Honest: Don't exaggerate your skills or experience.

Be Positive: Focus on your strengths and accomplishments.

Body Language: Maintain good posture, avoid fidgeting, and make eye contact.

Turn Off Phone: Avoid distractions during the interview.

Final Thought:

To prepare for your Utilization Review Specialist, Behavioral Health interview at Sutter Health, research the company, understand the job requirements, and practice common interview questions.

Highlight your leadership skills, achievements, and strategic thinking abilities. Be prepared to discuss your experience with HR, including your approach to meeting targets as a team player. Additionally, review the Sutter Health's products or services and be prepared to discuss how you can contribute to their success.

By following these tips, you can increase your chances of making a positive impression and landing the job!

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