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Utilization Review Analyst 

EOE StatementWe are an equal employment opportunity employer. All qualified applicants will receive consideration for employment without regard to race, color, religion, sex, national origin, disability status, protected veteran status or any other characteristic protected by law.

Utilization Review Analyst needed for full-time, temporary (3 month) assignment in Montgomery County.

Review and abstract pertinent data from medical records and communicates information to all various insurance companies and/or their contractual agencies to guarantee continued financial coverage.

Job Duties and Responsibilities:

  • Reviews admissions to determine medical necessity and appropriateness of treatment.
  • Interviews patients to obtain justification of treatment.
  • Secures necessary data for extended stay reviews.
  • Presents abstracts (via telecon) of clinical course of treatment to all various insurance companies and/or their contractual agencies, to justify continued treatment.
  • Review, abstracts and assigns initial length of stay and extensions of treatment as appropriate for Medicare, self-pay and private (non-pre-certification) insurance companies.
  • Communicates all extensions of treatment to clinical teams and Director, Concurrent Review.
  • Notify clinical teams of need for current documentation.
  • Refer cases to Director, concurrent Review when appropriateness of and necessity of extended stay is questionable.
  • Able to take and transcribe minutes for the Utilization Review Committee Meeting
  • Attend appropriate daily treatment team meeting
  • Assisting patients, family members and other customers with concern and empathy
  • Respect patient confidentiality and privacy
  • Communicate with all customers in a respectful and courteous manner
Position Requirements

BSW - Previous experience in hospital setting preferred. Requires good writing skills, ability to work independently, self-starter, ability to work under pressure, good interpersonal skills, computer literate, ability to interpret terminology and knowledge of addiction. Maintain cooperative courteous and respectful attitude in all interactions with patients, visitors and co-workers.


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