SonderMind is looking to hire a Utilization Review Analyst. In this role, you will be responsible for assessing clinical treatment notes/plans, and billing coding to determine appropriateness of care to ensure contract and coding obligations are met according to payor guidelines. This position will report directly to the Director of Revenue Operations and will work closely with other functional areas including the Chief Medical Officer to promote the highest level of clinical quality and patient outcomes.
Our Ideal Candidate
As our ideal candidate, you are an active Registered Nurse with previous experience in a behavioral health setting. You are a clear communicator, and are able to communicate effectively to clinical and non clinical teams. You are passionate about redesigning behavioral health, and are eager to join a high growth company
- Within one month, identify 10-20 unique billing encounters for clinical and billing audits. Formulate a methodology/algorithm to identify/flag high risk providers for review. Have a plan to start auditing provider claims and clinical notes.
- Within two months, be able to see improvements in provider notes and billings that were selected for audit. Partner with the product team to improve claim submission logic using formula/algorithm to flag/monitor claims for coding and billing quality.
- Within three months, have created and define clear metrics and process to promote best standards for providers billing practice and quality clinical notes
- 3+ years’ of clinical experience required
- 3+ years of healthcare coding/billing experience
- Active RN License
- Experience working in a behavioral health facility
- Strong analytical, organizational, verbal and written skills required
- Intermediate Excel skills (vlookup and pivot tables)
Nice to Have
- Previous experience in a utilization review role
- Experience in a start-up environment
- This role is located in Denver, CO and is a full-time, exempt position
- Salary range is starting at $65,000. Actual pay and title will be based on experience and skills.
- This role will be eligible to participate in the following:
- full employee benefits package
- employee stock option purchase plan
- variable performance-based bonus incentives
To apply please submit your resume and cover letter. In your cover letter, please explain how this role fits into your career goals and experience.
Commitment to an Inclusive Workplace
Mental wellness impacts people of every community. At SonderMind, building and supporting a diverse workforce is foundational to our goal to redesign behavioral healthcare to be more approachable and accessible. SonderMind is a committed equal opportunity employer and provides a workplace that will not tolerate discrimination or harassment.
Our employees may be exposed to sensitive personal information throughout their regular duties. For this reason, we maintain exceptionally high expectations of ethical conduct and require all incoming employees to pass a background check.
Our Employee Benefits Philosophy
As a leader in redesigning behavioral health we are walking the walk with our employee benefits package. We focus on meeting SonderMinders wherever they are and supporting them in all facets of their life with both mental and physical aspects in mind. Where most companies say "good enough" we ask ourselves "how can we do better." That includes:
- Therapy coverage benefits to enable our employees to get the care they need
- Employer-paid disability & AD&D to cover life's unexpected - not only that, we cover the difference in salary for up to Eight weeks of short-term disability leave
- Eight weeks of paid parental leave (if the parent also qualifies for STD, this benefit is in addition)
- A generous PTO policy and a company mandate of at MINIMUM three-weeks of PTO a year; flexible work-from-home policy
- A commitment to reward our team members for the long-term success and growth of SonderMind with stock option grants and bonus potential
- Competitive market salary, up-to 4% salary company match on 401K, professional development and advancement opportunities as we rapidly scale, and so much more.