Utilization Reviewer / Management Analyst 2

The State of Minnesota is dedicated to improving the well-being of its residents and is seeking a Utilization Reviewer. This role involves assessing patient medical records to ensure the necessity of treatment and services, conducting both on-site and electronic reviews, and coordinating with billing processes.ResponsibilitiesConduct electronic admission and medical record reviews to assess level of care and program service needsParticipate in data collection and analysis of utilization management informationCoordinate utilization review activities with program’s billing processesParticipate in development and implementation of utilization management training effortsSkillsOne (1) year of experience in health care utilization review that demonstrates the following: Experience in health insurance and/or billing. Experience with admission reviews and continued stay reviews. Data collection and analysis using computer systems and applications. Collaborating with third-party payers and service providersORThree (3) years administrative support experience in health care utilization review that demonstrates the following: Experience in health insurance and/or billing. Process and enter verified data using computer systems and applications. Support and communicate data in a clear and concise manner. Support in the completion of admission reviews and continued stay reviews. Collaborating with third-party payers and service providersA bachelor's degree in psychology, business management, healthcare administration, nursing or related field may substitute for 1 year of advanced technical or paraprofessional experienceTo facilitate proper crediting, please ensure that your resume clearly describes your experience in the areas listed and indicates the beginning and ending month and year for each job heldREFERENCE/BACKGROUND CHECKS – Direct Care & Treatment will conduct reference checks to verify job-related credentials and criminal background check prior to appointmentEDUCATION VERIFICATION - Applicants will be required to provide a copy of their high school diploma at time of interview OR copies of their college transcript or college degree/diploma at time of interview. Copies of the college degree/diploma are acceptable ONLY if it clearly identifies the field in which it was earnedDirect Care & Treatment (DCT) healthcare facilities require employees to provide documentation that they are free from tuberculosis (TB) through a blood test prior to employment. DCT does not accept TB skin testingBachelor's degree in psychology, business management, healthcare administration, nursing, or related fieldExperience with care delivery in a behavioral health facilityPreferred candidates will have a variety of experiences working effectively with others from different backgrounds and culturesBenefitsPaid vacation and sick leave12 paid holidays each yearAnnual pay increasesLow-cost medical, dental, vision, and prescription drug plansFertility care, including IVFDiabetes careDental and orthodontic care for adults and children6 weeks paid leave for parents of newborn or newly adopted childrenPension plan that provides income when you retire (after working at least three years)Employer paid life insurance to provide support for your family in the event of deathShort-term and long-term disability insurance that can provide income if you are unable to work due to illness or injuryTax-free expense accounts for health, dental, and dependent careResources that provide support and promote physical, emotional, social, and financial well-beingTraining, classes, and professional developmentFederal Public Service Loan Forgiveness Program (Some positions may qualify for the Public Service Loan Forgiveness Program. For more information, visit the Federal Student Aid website at studentaid.gov)Employee Assistance Program (EAP) for work/life supportA voluntary confidential program that helps employees and their families with life challenges that may impact overall health, personal well-being, or job performanceCommon sources of stress can be addressed through the EAP: mental health, relationship challenges (personal and work), grief and loss, finances, and legal issuesDaily Living/Convenience Services: Chore services, home repair, trip planning, child/elder careCompany OverviewState of Minnesota provides information for residents, businesses, government, employment, education, and travel. It was founded in 1858, and is headquartered in Saint Paul, Minnesota, USA, with a workforce of 10001+ employees. Its website is https://mn.gov.



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