Utilization Review Specialist

4 weeks ago


Smyrna, Georgia, United States Ridgeview Institute Smyrna Full time

About the Role:

We are seeking a highly skilled Utilization Review Specialist to join our team at Ridgeview Institute Smyrna. As a Utilization Review Specialist, you will play a critical role in assessing patient care plans and determining the most cost-effective treatment options.

Key Responsibilities:

  • Review treatment plans and advocate for additional services as indicated.
  • Maintain ongoing contact with attending physicians, program managers, nurse managers, and team members.
  • Collaborate with the treatment team regarding continued stay and discharge planning issues.
  • Advocate for patients to be placed in the appropriate level of care and program.
  • Interface with program staff to facilitate a smooth transition during transfer or discharge.
  • Assure tracking of insurance reviews and that reviews are completed on time.
  • Maintain statistical reports and prepare documentation of significant findings.

Requirements:

  • Bachelor's or Master's degree from an accredited college or university in social work, mental health, nursing, or related degree preferred.
  • A minimum of two (2) years of related experience in a healthcare setting or managed care company, with experience in patient assessment, treatment planning, utilization management, and/or case management preferred.
  • Must maintain a valid driver's license in the applicable state. LMSW/RN preferred.

What We Offer:

  • Competitive hourly rate of $18.00 to $25.00/hour.
  • 401(k) + matching.
  • Health insurance.
  • 100% company-paid life insurance coverage up to 2x your annual salary.
  • Vision insurance.
  • Dental insurance.
  • 100% company-paid long term disability insurance.
  • Paid time off.
  • Paid Holidays.
  • Cafeteria on site + one free meal per day.
  • Employee engagement events.
  • Employee assistance program.
  • Employee recognition program.
  • Free parking.

About Us:

Ridgeview Institute Smyrna is a premier healthcare provider in Smyrna, GA, setting the gold standard for excellence in mental health and addiction treatment support. We take pride in offering dynamic, challenging, and highly rewarding positions. Join us in providing exceptional care and contributing to the well-being of individuals and families in need.



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