Utilization Review Specialist PRN, Behavioral Health

Fort Worth, TX - USA

Monthly Salary: Not Disclosed

Posted on: Yesterday

Vacancies: 1 Vacancy

Job Summary

Description

PRN Position for Inpatient and Outpatient (PHP/IOP) Utilization.

Your experience matters

Mesa Springs is part ofLifepoint 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. As a Utilization Review Specialist 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.

How youll contribute

AnUtilization 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.
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.

What were looking for
Applicants should have aBachelors degree (required) Masters degree preferred. Additional requirements include:

Current unencumbered clinical license strongly preferred
CPR and CPI Certification within 30 day of employment
Previous utilization review experience in a psychiatric healthcare facility preferred.

More about Mesa Springs

Mesa Springsis a behavioral health hospitaloffering 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:

DescriptionPRN Position for Inpatient and Outpatient (PHP/IOP) Utilization.Your experience mattersMesa Springs is part ofLifepoint 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 ...

Description

PRN Position for Inpatient and Outpatient (PHP/IOP) Utilization.

Your experience matters

How youll contribute

AnUtilization 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.
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.

What were looking for
Applicants should have aBachelors degree (required) Masters degree preferred. Additional requirements include:

Current unencumbered clinical license strongly preferred
CPR and CPI Certification within 30 day of employment
Previous utilization review experience in a psychiatric healthcare facility preferred.

More about Mesa Springs

Mesa Springsis a behavioral health hospitaloffering exceptional care to the Fort Worth TX community.

EEOC Statement

Required Experience:

Apply Now

About Company

Lifepoint Health

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

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