The Utilization Review Specialist responsibilities include the following: Overseeing the Utilization Review program for in-patient and residential services. This includes the implementation of case management scenarios, consulting with all services to ensure the provision of an effective treatment plan for all patients, oversees the response to requests for services and interfaces with managed care organizations, external reviewers, and other payers.
Qualified candidates for Utilization Review Specialist should have the following: Education: Master's degree in healthcare field preferred
Bachelor's degree in healthcare field is required.
Experience: A minimum of two years (2) years direct clinical experience in a psychiatric or mental health treatment setting, including one year of managing a related function preferred. Experience in patient assessment, family motivation, treatment planning and communication with external review organizations or comparable entities preferred.
Licensure: OPTIONAL
Must be able to function independently while having great interdepartmental communication. Great time management skills. Must be able to understand and identify the severity of medical necessity criteria for both inpatient and residential behavior health. Scheduling: Full-Time - Work hours are generally Monday through Friday, 8:00am - 4:30pm Our benefits include the following: Service excellence and fulfilling work environment 401(k) plan and company match Health Insurance Dental Insurance Vision Insurance Life Insurance Paid Time Off Supplemental Insurance Plans Available To learn more about the company, please visit our website at: Perimeter Healthcare is one of the leading behavioral health care providers in the country for children, adolescents, adults, and senior adults. We deliver hope to our patients through the delivery of comprehensive and dedicated treatment programs. Our focus and commitment on service excellence is available across several states and in different care settings. Our team ensures our patients receive the required care that they or their loved one needs. We offer several programs for our patients including inpatient acute treatment and residential treatment. We are seeking staff who exhibit daily the following values: C- Compassion A- Accountability R – Respect and E- Empowerment. EEO We are committed to providing an environment of diversity and inclusion where equal opportunities are available to all applicants and fellow employees. Perimeter Behavioral Health is an equal opportunity employer regarding all recruitment, training, and selection process within the company regarding race, color, religion, age, sex, sexual orientation, pregnancy, and gender identity, genetic information, national origin, disability status, protected veteran status, or any other characteristic protected by federal, state, or local laws.
