Utilization Review Specialist - Behavioral Health
Utilization Review Specialist - Behavioral Health
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Salary Not Disclosed
1 Vacancy
Job Description
Schedule: Full-Time Days
Your experience matters
How youll contribute
AUtilization Review Specialistwho excels 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.
Participates in treatment teams to ensure staff have knowledge of coverage and to collect information for communication with agencies.
Works with DON to ensure documentation requirements are met.
Ensures appeals are completed thoroughly and on a timely basis.
Interfaces with managed care organizations external reviews and other payers.
Communicates with physicians to schedule peer to peer reviews.
Accurately reports denials.
Why join us
We believe that investing in our employees is the first step to providing excellent patient addition to your base compensation this position also offers:
Comprehensive Benefits:Multiple levels of medical dental and vision coverage for full-time andpart-time employees.
Financial Protection & PTO:Life accident critical illness hospital indemnity insurance short- and long-term disability paid family leave and paid time off.
Financial & Career Growth:Higher education and certification tuition assistance loan assistance and 401(k) retirement package and company match.
Employee Well-being:Mental physical and financial wellness programs (free gym memberships virtual care appointments mental health services and discount programs).
Professional Development:Ongoing learning and career advancement opportunities.
What were looking for
Applicants should have a bachelors degree masters degree preferred. Additional requirements include:
Previous utilization review experience in a psychiatric healthcare facility preferred
Current unencumbered clinical license strongly preferred
CPR certification and Crisis Prevention Training
Leadership Experience Preferred
Connect with a Recruiter
Not ready to complete an application or have questions Please contact Jennifer by emailing
More about Mesa Springs
Mesa Springsis a Behavioral Health hospital offering exceptional care to the Fort Worth TX community
EEOC Statement
Mesa Springsis an Equal Opportunity Employer.Mesa Springsis committed to Equal Employment Opportunity for all applicants and employees and complies with all applicable laws prohibiting discrimination and harassment in employment.
Required Experience:
Unclear Seniority
Employment Type
Full-Time
