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Utilization Review Specialist
2 months ago
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