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Behavioral Health Utilization Review Specialist

2 months ago

Olathe Kansas, United States Springstone, Inc. Full time
About the Role

Cottonwood Springs, a leading behavioral health organization, is seeking a skilled Utilization Review Specialist to join our team. As a key member of our clinical review team, you will play a critical role in ensuring our patients receive the necessary treatment and care.

Key Responsibilities
  • Act as a liaison between managed care organizations and our facility's behavioral health clinical treatment team.
  • Conduct clinical reviews in accordance with certification requirements of insurance plans or other managed care organizations.
  • Monitor patient length of stay and conduct initial and concurrent reviews when indicated to provide clinical information needed to support medical necessity criteria for appropriate level of care.
  • Facilitate peer-to-peer reviews between the facility treatment provider and the managed care physician.
  • Assist the Assessment Department with completion of the precertification process for admissions.
  • Provide ongoing support and training for staff on documentation requirements, admission and continued stay criteria, and medical necessity updates.
Requirements
  • Bachelor's degree
  • CPR and CPI Certification within 30 days of employment
  • Previous utilization review experience in a psychiatric healthcare facility preferred
What We Offer

Cottonwood Springs offers a collaborative work environment, competitive compensation, and flexible scheduling. Our team members enjoy working with a highly engaged staff, healthy staffing levels, and opportunities for career growth.