Utilization Review Specialist
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Job Location:
Helena, MT - USA
Monthly Salary:
Not Disclosed
Posted on:
Yesterday
Vacancies:
1 Vacancy
Job Summary
About the Role
The Utilization Review Specialist supports timely appropriate patient care by managing utilization review activities across inpatient outpatient and residential services. This role coordinates authorizations reviews clinical documentation ensures medical necessity and serves as a key liaison between treatment teams Medicaid and private insurance payors.
Ideal Candidate
- Strong clinical understanding of mental health and level-of-care criteria.
- Experienced with Medicaid/private insurance authorizations pre-auths and appeals.
- Highly organized detail-oriented and able to manage multiple referrals and deadlines.
- Excellent written and verbal communication; professional clear and collaborative.
- Calm under pressure compassionate with youth and families and maintains a positive demeanor.
- Proficient in Epic insurance portals and standard office software.
Why Join Shodair
Youll be part of a collaborative mission-driven team dedicated to improving access to mental health services for children and families across Montana. Shodair offers comprehensive benefits including student loan assistant 6% 403b employer paid contribution paid medical and vision insurance sick leave and much more. This position starts at $23.65 per hour.
Qualifications
- Bachelors degree in social work psychology nursing or related field (or equivalent experience).
- Experience in mental health or crisis intervention preferred.
Required Experience:
IC
Key Skills
- Sales Experience
- Crane
- Customer Service
- Communication skills
- Heavy Equipment Operation
- Microsoft Word
- Case Management
- OSHA
- Team Management
- Catheterization
- Microsoft Outlook Calendar
- EHS
