Utilization Review AnalystEagleville Hospital, an independent substance use and behavioral health treatment and educational organization serving the community for more than a century, provides innovative compassionate care to those seeking treatment for stigmatized illnesses including substance use and mental health.Position SummaryReview 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.This position reports to the Utilization Review DirectorObjectives / ResponsibilitiesReviews admissions to determine medical necessity and appropriateness of treatment.Reviews patient records to obtain justification of treatment.Secures necessary data from the clinical team 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 all payers as assignedCommunicates all extensions of treatment to clinical teams and Director, Utilization Review (UR)Notify clinical teams of need for current documentation.Refer cases to Director, UR when appropriateness of and necessity of extended stay is questionable.Attend appropriate daily treatment team meetingSalary Range: $50-$57/yrQualificationsBachelor's Degree PreferredCompetenciesPatient-Centered Approach – Treat all individuals with dignity, empathy, and respect, recognizing that every role contributes to the patient experience.Excellence & Accountability – Perform all duties with professionalism, following hospital policies to ensure safety, compliance, and efficiency.Teamwork & Communication – Collaborate with colleagues across departments, maintaining a positive and solution-oriented attitude.Commitment to Our Mission – Uphold the hospital's values and contribute to a culture of trust, inclusivity, and continuous improvement.Qualifications3+ years of UR or case management experience in Substance Use /Behavioral HealthGood communicationAbility to work independentlyExperience with Microsoft applicationsKnowledge of pre-certification process and ASAM. Knowledge of DSM V, private care managers and county referral sourcesPhysical RequirementsAbility to sit for long periodsAbility to walk around campus if neededGood dexterity, must be able to typeUse of telephoneWork EnvironmentOffice setting