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Utilization Review Specialist

2 months ago


Olathe, Kansas, United States Cottonwood Springs Full time

About the Role:

Cottonwood Springs is seeking a highly skilled Utilization Review Specialist to join our team. As a Utilization Review Specialist, you will play a critical role in ensuring that 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 our facility's 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:

  • A dynamic and supportive work environment
  • Opportunities for career growth and professional development
  • A comprehensive benefits package, including health, vision, dental, and 401(k) plans
  • UKG Wallet, a voluntary Earned Wage Access benefit