Utilization Review Specialist
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Job Location:
Lynchburg, VA - USA
Monthly Salary:
Not Disclosed
Posted on:
30+ days ago
Vacancies:
1 Vacancy
Job Summary
Schedule: Full Time Days
Your experience matters
Centra Behavioral Health Hospital is part of Lifepoint Health a diversified healthcare delivery network with facilities coast to coast. We are driven by a profound commitment to prioritize your well-being so you can provide exceptional care to others. By joining our team youre embracing a vital mission dedicated to making communities healthier . Join us on this meaningful journey where your skills compassion and dedication will make a remarkable difference in the lives of those we serve.
Come join us in our journey of opening a brand-new hospital!
More about our team
Centra Behavioral Health Hospital is a brand-new 72 bed behavioral health facility opening in 2026. We offer high-quality compassionate care for a wide variety of patients in need. Our teams provide evidence-based transformational care for a broad range of mental health concerns in a compassionate comfortable environment.
How youll contribute
A Utilization Review Specialist who 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.
Participate 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.
Ensure appeals are completed thoroughly and on a timely basis.
Interface with managed care organizations external reviews and other payers.
Communicate with physicians to schedule peer to peer reviews.
Accurately report 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.
- Brand new facility: Brand new hospital built from the ground up with cutting edge equipment and technology!
What were looking for
Applicants should possess the following qualifications and skills:
Education: Bachelors degree required. Masters degree preferred
Experience: Previous utilization review experience in a psychiatric healthcare facility preferred.
License: Current unencumbered clinical license strongly preferred.
Additional Requirements: CPR certification and Crisis Prevention Training (CPI) preferred. May be required to work flexible hours and overtime.
About Us
Centra Behavioral Health Hospital is a 72-bed behavioral health hospital committed to offering exceptional care to the Lynchburg community. We are part ofLifepoint Health a diversified healthcare delivery network committed to making communities healthier with acute care rehabilitation and behavioral health facilities from coast to coast.
EEOC Statement
Centra Behavioral Health Hospital is an Equal Opportunity Behavioral Health Hospital is committed to Equal Employment Opportunity for all applicants and employees and complies with all applicable laws prohibiting discrimination and harassment in employment.
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
About Company
Lifepoint Health is a leader in community-based care and driven by a mission of Making Communities Healthier. Our diversified healthcare delivery network spans 29 states and includes 63 community hospital campuses, 32 rehabilitation and behavioral health hospitals, and more than 170 a ... View more
