Overview
Fully On-Site Role
Utilization Review Specialist
Salary/Hourly: $23- $31.00/hour
Members of our team Enjoy:
Working with a highly engaged staff
Healthy staffing levels
Flexible scheduling
Career growth
Competitive compensation
Health, Vision, Dental, 401k, and Paid Time Off
UKG Wallet - We've partnered with UKG Wallet, a voluntary Earned Wage
Access benefit, to offer employees access to their pay on their own schedule.
Denver Springs is a 96-bed behavioral hospital located in Englewood, CO. The
hospital offers inpatient and outpatient mental health and addiction treatment
to adults, adolescents and their families. At Denver Springs we are
dedicated to Changing People's Lives.
The Utilization Review department plays an essential role in helping fulfill
our mission of "Changing People's Lives". Utilization Review team
members advocate on behalf of our patients to managed care providers for
necessary treatment. As a Utilization Review Specialist, you will
accurately and timely complete utilization review activities.
Position Details
Acts as a liaison between managed care organizations and the facility's
behavioral health clinical treatment team.
Conducts clinical reviews in accordance with certification requirements of
insurance plans or other managed care organizations.
Monitors patient length of stay and conducts initial and concurrent reviews
when indicated to provide clinical information needed to support medical
necessity criteria for appropriate level of care.
Facilitates peer to peer reviews between the facility treatment provider and
the managed care physician.
Assists the Assessment Department with completion of the precertification
process for admissions.
Provides ongoing support and training for staff on documentation
requirements, admission and continued stay criteria, and medical necessity
updates.
Qualifications
Qualifications:
Knowledge of mental health and chemical dependency terminology, symptoms,
diagnoses, and treatment.
Ability to communicate effectively with patients, internal and external
treatment providers, and managed care clinical review care managers.
Ability to multi-task, pay attention to detail, problem solve, utilize
critical thinking skills, prioritize, and work both independently and as a
part of a team.
Strong computer skills and ability to navigate electronic systems applicable
to job functions.
Requirements:
Bachelor's degree or current clinical license required in lieu of degree
CPR and CPI Certification within 30 days of employment
Previous utilization review experience in a psychiatric healthcare facility
preferred
Education and experience in the field(s) of: Social Work,
Psychology, Psychiatric Nursing, Marriage and Family and Child
Counseling, Chemical Dependency Counseling, Registered Nursing or a
closely related science field
Equal Opportunity Employer Minorities/Women/Veterans/Disabled
Springstone, Inc. is an Equal Opportunity Employer. All qualified applicants
will receive consideration for employment without regard to race, color,
religion, sex, sexual orientation, gender identity, national origin,
or protected veteran status and will not be discriminated against on the basis
of disability.