Utilization Review Specialist

3 weeks ago

Fort Worth, United States WellBridge Healthcare Full time
Job DescriptionDescription

Utilization Review Specialist (URS) - Behavioral Health

WellBridge Fort Worth, part of Lifepoint Behavioral Health, nationally known healthcare organization with diversified delivery network with facilities from coast to coast, seeks passionate, patient-centric, and goal-oriented team members to join our team. We specialize in compassionate behavioral health services, including crisis stabilization, inpatient care, and outpatient treatment for acute mental health and substance use treatment. Our philosophy is built on a psychosocial model of care to decrease suicide rates, decrease addiction-related deaths, reverse the decline in life expectancy, and improve productivity in the communities we serve. We offer a collaborative work environment, competitive compensation, and flexible scheduling so you can focus on what really matters–providing quality patient care. Join our team in Fort Worth, Texas to build a career that touches lives.

Benefits

  • Affordable medical, dental and vision plans provided to meet the needs of full employees and their families

  • Up to 16 days of PTO for full time employees

  • 6 paid holidays for full time employees

  • Tuition reimbursement

  • 401(k) retirement plan

  • Flexible spending and health savings accounts

What you will do in this role:

  • Displays knowledge of clinical criteria, managed care requirements for inpatient and outpatient authorization and advocates on behalf of the patient to secure coverage for needed services.

  • Completes pre and re-certifications for inpatient and outpatient services. 

  • Reports appropriate denial, and authorization information to designated resource.

  • Actively communicates with interdisciplinary team to acquire pertinent information and give updates on authorizations.

  • Participate in treatment teams to ensure staff have knowledge of coverage and to collect information for communication with agencies.

  • Other Duties as assigned.
Qualifications

Qualifications:

  • Bachelor’s degree required. Master’s degree preferred.

  • Previous utilization review experience in a psychiatric healthcare facility preferred.

  • Current unencumbered clinical license strongly preferred.

  • CPR certification and Crisis Prevention Training (CPI) preferred.

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