Utilization Management Communication Specialist

Gateway Foundation, Inc. Lake Villa , IL 60046

Posted 2 months ago

As Illinois' largest provider of substance abuse treatment, joining the team at Gateway Foundation Alcohol & Drug Treatment offers valuable experience with a variety of treatment methods as well as an opportunity to collaborate with skilled experts about a diverse clientele. Gateway welcomes the challenge of constant improvement and is proud to uphold the Joint Commission Gold Seal of Approval. In addition to a competitive salary, Gateway offers employees health benefits, dental insurance, career advancement, training and development and on-site clinical supervision to individuals pursuing certifications and licensures.

Utilization Management Specialists are responsible for:

  • Obtaining initial and subsequent authorizations of clinical services from insurance and government payors

  • Reviewing clinical records and determining the appropriateness of patient admission, level of care, continued length of stay, and discharge

  • Providing training and support to clinical treatment staff on the insurance authorization process

  • Assisting staff with preparing peer-to-peer reviews and clinical appeals by advising them on presenting case information in accordance with established procedures

  • Preparing regular summary reports and presentations on utilization management data

  • Other duties as assigned

Requirements Requirements:

  • Current IL licensure as a Registered Nurse; or Masters' degree in social work, psychology, mental health or substance abuse counseling and certification (CADC) or licensure (LPC, LSW, LCPC or LCSW) in the state of Illinois required

  • 1+ years of experience with the utilization management process in a healthcare setting

  • This is a full-time position working Monday

  • Friday, daytime hours

Competitive Compensation and Benefits:

Gateway Foundation values its employees and provides an inclusive and diverse work environment where dedicated employees can make a difference. We are committed to engaging and rewarding our employees in meaningful ways. For eligible employees, we provide a Total Rewards Package that includes:

  • Health Insurance
  • Including a wellness premium incentive opportunity
  • Dental & Vision Insurance

  • Paid Time Off

  • Including 18 days of PTO and 9 paid holidays in the first year
  • Catastrophic Absence Time (CAT) - Accrue up to seven days annually, to be used during an extended personal illness

  • Flexible Spending Accounts

  • Commuter Accounts

  • 403(b) Retirement Plan with company match

  • Life and AD&D Insurance

  • Long-Term Disability (LTD)

  • Employee Assistance Program (EAP)

  • Gateway is a qualified employer for Public Service Loan Forgiveness (PSLF)

  • Tuition Reimbursement

  • Training & Development Programs

Gateway Foundation is an Equal Opportunity Employer: Race/Color/Sex/Sexual Orientation/ Gender Identity/Religion/National Origin/Disability/Vets.

  • Gateway Foundation is an Equal Opportunity Employer: Race/Color/Sex/Sexual Orientation/ Gender Identity/Religion/National Origin/Disability/Vets.

  • Please view Equal Employment Opportunity Posters provided by OFCCP here.

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Utilization Management Communication Specialist

Gateway Foundation, Inc.