Job: Utilization Review Specialist

Tully Hill Treatment & Recovery

Join the team of professionals at a nationally recognized treatment facility.

Do you have a passion for helping others? Tully Hill Treatment and Recovery is dedicated to the belief that substance use disorder is a disease – chronic, progressive and above all, treatable. Join the multidisciplinary team of professionals committed to helping patients and families live sober, productive, happy lives, free of addiction and its aftermath.

At Tully Hill recovery happens every day, 365 days a year. Treatment at Tully Hill means healing the mind, the body, and the soul. Our holistic approach to recovery emphasizes education as we help patients learn new coping methods, sober living skills, and how to create and keep sober support systems.

Tully Hill is accepting applications for an experience professional to join our team as Utilization Review Specialist. Will be responsible for providing clinical and medical information to insurance companies and third party payers to justify initial admission and continued stay coverage and prevent denial of payment, researching and communicating insurance companies’ treatment requirements to the treatment team, facilitating appeals of patient claims, coordinating with the multidisciplinary treatment team to ensure appropriate level of care via treatment and care documentation that meets payers’ treatment and care criteria, reviewing medical records for completeness of necessary clinical, nursing and medical information and communicating deficiencies to the treatment team. Will assist in conducting the pre-admission and admission processes by interviewing, screening and evaluating potential patients, obtaining treatment authorization, communicating patient financial responsibilities and documenting pertinent patient information into electronic medical record.

Our goal is to hire an experienced professional who has the ability to work as part of a multi-disciplinary team. Qualified individuals must have the ability to work in a fast-paced environment. Strong written and verbal communication skills, competency in an electronic medical record and good computer skills required. Current RN or LPN licensure or other NYS QHP certification required. Must ensure quality, timeliness and accuracy of documentation to ensure compliance with CARF standards, NYS OASAS regulations, other applicable State and Federal regulations, referral source and insurance contract and reimbursement requirements. Demonstrable knowledge of substance use disorders, 12-Step philosophy and commercial health insurance preferred. Previous utilization review / managed care work experience a plus.

Tully Hill Treatment and Recovery, a 501c3 not-for profit corporation, is mission driven and follows a business model. Tully Hill offers a high energy, compassionate, professional environment in a beautiful well maintained property. Salary is commensurate with experience and education/credentials. Comprehensive benefits package includes health insurance, 401(k) plan, vacation, sick and personal time, paid holidays, company paid short-term disability insurance, voluntary dental insurance, voluntary additional disability insurance and voluntary life insurance.

Tully Hill Treatment & Recovery has remained committed to serving individuals, families and our communities affected by substance use disorder during the coronavirus pandemic. Tully Hill’s safety/infection record is exceptionally good throughout the pandemic. Candidates will be required to show proof of being fully vaccinated against COVID-19, including a booster shot when eligible, upon commencing employment. Reasonable accommodations will be considered on a case-by-case basis for exemption to this requirement in accordance with applicable law.

Tully Hill is committed to providing the highest quality services to our patients while balancing the workload of our caregivers. Our success has been, and will continue to be, achieved by working together as a team and communicating effectively. Staff at Tully Hill are valued and critical to our mission.

Download and send a completed Application, Resume,and Salary Requirements to:

Email: resumes@tullyhill.com

Fax: 315-413-5105

Mail:
Tully Hill Corporation
Attn: Human Resources
PO Box 1116
Tully, NY 13159

It is the policy of Tully Hill Corporation to provide equal employment opportunities to all applicants and employees without regard to race, color, citizenship status, religion, sex, sexual orientation, marital status, age, national origin, status as an individual with a disability or as a disabled and/or Vietnam Era veteran or any other legally protected status and to affirmatively seek to advance the principles of equal employment opportunity.