SEARHC is a non-profit health consortium which serves the health interests of the residents of Southeast Alaska. We see our employees as our strongest assets. It is our priority to further their development and our organization by aiding in their professional advancement.
Working at SEARHC is more than a job, it’s a fulfilling career. We offer generous benefits, including retirement, paid time off, paid parental leave, health, dental, and vision benefits, life insurance and long and short-term disability, and more.
This position oversees the day-to-day requirements of Utilization Management & Review, authorizing acute and sub-acute admissions at the Southeast Alaska Regional Health Consortium (“SEARHC”) Mount Edgecumbe Medical Center. This position works intensively with advanced systems to track and trend denials, build models for documentation improvement plans, and coordinate with all areas and levels of the hospital. This position works closely with the provider community to improve clinical documentation, and with administration to ensure appropriate utilization of hospital resources.
Under general supervision, provides professional assessment, planning, coordination, implementation, and reporting of complex clinical data. Maintains compliance with regulations affecting utilization management. Provider communication and behavior change can be challenging; this individual must be a master communicator and change agent. Clinical background required, as this position will be required to read, rapidly synthesize, and narrate a clinical event to patients’ third-party coverage for accurate and timely authorization and reimbursement. Must be able to understand and manipulate advanced systems and work with and synthesize large relational data sets, providing descriptive/predictive/prescriptive analytics to modify facility operational behavior.
Knowledge, Skills & Abilities: