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.

Responsibilities

• Conduct electronic admission and medical record reviews to assess level of care and program service needs
• Participate in data collection and analysis of utilization management information
• Coordinate utilization review activities with program’s billing processes
• Participate in development and implementation of utilization management training efforts

Skills

• One (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 providers
• OR
• Three (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 providers
• A bachelor's degree in psychology, business management, healthcare administration, nursing or related field may substitute for 1 year of advanced technical or paraprofessional experience
• To 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 held
• REFERENCE/BACKGROUND CHECKS – Direct Care & Treatment will conduct reference checks to verify job-related credentials and criminal background check prior to appointment
• EDUCATION 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 earned
• Direct 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 testing
• Bachelor's degree in psychology, business management, healthcare administration, nursing, or related field
• Experience with care delivery in a behavioral health facility
• Preferred candidates will have a variety of experiences working effectively with others from different backgrounds and cultures

Benefits

• Paid vacation and sick leave
• 12 paid holidays each year
• Annual pay increases
• Low-cost medical, dental, vision, and prescription drug plans
• Fertility care, including IVF
• Diabetes care
• Dental and orthodontic care for adults and children
• 6 weeks paid leave for parents of newborn or newly adopted children
• Pension 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 death
• Short-term and long-term disability insurance that can provide income if you are unable to work due to illness or injury
• Tax-free expense accounts for health, dental, and dependent care
• Resources that provide support and promote physical, emotional, social, and financial well-being
• Training, classes, and professional development
• Federal 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 support
• A voluntary confidential program that helps employees and their families with life challenges that may impact overall health, personal well-being, or job performance
• Common sources of stress can be addressed through the EAP: mental health, relationship challenges (personal and work), grief and loss, finances, and legal issues
• Daily Living/Convenience Services: Chore services, home repair, trip planning, child/elder care

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