Are you looking to find personal and professional fulfillment, and align your career with your values?
At Gateway Foundation, our employees have an opportunity to make a difference every day by helping people with substance abuse issues gain control of their lives.
Gateway Foundation is a recognized non-profit leader in evidence-based treatment proven to get results. Our experts in Addiction Medicine-including highly educated clinical and medical professionals and expert psychiatrists and nurses-deliver care that never stops. Throughout Gateway's proud history of helping others, dedicated and professional employees have been vital to accomplishing our life-saving mission.
If you are a collaborative professional who shares our commitment to helping people with substance abuse and mental health issues turn their lives around - GATEWAY IS THE PLACE FOR YOU!
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
Job 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
Physical Requirements:
- Proofreading and checking documents for accuracy on a continual basis (critical).
- Ability to use a keyboard and video display terminal to receive, retrieve, and/or audit information and data.
- Ability to respond to telephones, pages and speech.
- Normal or corrected vision in order to read and audit files.
- Ability to operate a motor vehicle safely and remain alert to traffic signs and conditions in order to travel to assigned sites.
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
- Flexible Spending Accounts and Health Saving Account
- Commuter Accounts
- 403(b) Retirement Plan with company match
- Life and AD&D Insurance
- Short Term Disability (STD) and 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. Please view Equal Employment Opportunity Posters provided by OFCCP here.