Utilization Management Specialist, Psychiatric Admissions and Referral, Days - University of Maryland Medical System

Looking for candidates with specific psychiatry, mental health, behavioral health insurance authorizations experience. The ideal person would have experience with psychiatry inpatient prior authorizations, as well as with insurance verification of eligibility and benefits

Renowned as the academic flagship of the University of Maryland Medical System, our Magnet®-designated facility is a nationally recognized, academic medical center with opportunities across the continuum of care.  Come join UMMC and discover the atmosphere where talents and ideas come together to enhance patient care and advance the science of nursing.  Located in downtown Baltimore near the Inner Harbor and Camden Yards, you won’t find a more vibrant place to work! 

This position is located at University of Maryland Medical Center (UMMC) in the Psychiatric Admissions and Referral Center (PARC). PARC is the administrative logistics center for inpatient psychiatry admissions at UMMC Downtown and Midtown campuses, as well as to our adult psychiatric day hospital programs at UMMC Midtown. 

Under general supervision, provides utilization review and denials management for an assigned patient case load. This role utilizes nationally recognized care guidelines/criteria to assess the patient’s need for outpatient or inpatient care as well as the appropriate level of care. The role requires interfacing with the case managers, medical team, other hospital staff, physician advisors, and payers.

Education and Experience

• Prior experience in psychiatry, mental health, or behavioral health is required. 
• Licensure as a Social Worker or Registered Nurse or other equivalent health care license in the state of Maryland, or eligible to practice due to Compact state agreements outlined through the MD Board of Nursing, is required

All your information will be kept confidential according to EEO guidelines.