New

Utilization Review Assistant (Mon-Fri 8A-5P)

Acadia Pharmaceuticals Inc.
United States, Tennessee, Memphis
Jan 29, 2025
Provide administrative support to the Admissions and Utilization department. ESSENTIAL FUNCTIONS: Perform pre-certification and negotiate continued stay with third party payers. Gather data to support case management activities, including presentation of gathered data and case notes. Coordinate discharge planning with clinical team, maintain CRM database with discharge information and follow up. Present case information and the needs of third-party payers to (?). Assist in admissions review, concurrent reviews and discharge planning. Assist physician in peer review by serving as information resource, gather data to support review and schedule peer review. Informs management about the status of current patients; documents utilization activities as instructed. Participates in performance improvement activities. OTHER FUNCTIONS: Perform other functions and tasks as assigned. EDUCATION/EXPERIENCE/SKILL REQUIREMENTS: High school diploma or equivalent required. Bachelors or Master's decree preferred. LICENSES/DESIGNATIONS/CERTIFICATIONS: Current certification as Registered Addiction Specialist, certified Substance Abuse Counselor or similar certification preferred. Equal Opportunity Employer/Protected Veterans/Individuals with Disabilities The contractor will not discharge or in any other manner discriminate against employees or applicants because they have inquired about, discussed, or disclosed their own pay or the pay of another employee or applicant. However, employees who have access to the compensation information of other employees or applicants as a part of their essential job functions cannot disclose the pay of other employees or applicants to individuals who do not otherwise have access to compensation information, unless the disclosure is (a) in response to a formal complaint or charge, (b) in furtherance of an investigation, proceeding, hearing, or action, including an investigation conducted by the employer, or (c) consistent with the contractor's legal duty to furnish information. 41 CFR 60-1.35(c)