Psychiatric Utilization Review Specialist

Universal Health Services; Louisville (CO); On-site; USD 65,000 - 90,000; Full time

Benefits offered by this job

Competitive compensation

Generous paid time off

Excellent medical, dental, vision

Job summary

Centennial Peaks Hospital in Louisville, CO, part of Universal Health Services, provides psychiatric services including inpatient, electroconvulsive therapy, and outpatient programs. The Utilization Review Coordinator assesses medical necessity and negotiates care with insurers within a multidisciplinary team.

The role requires 3–5 years of psychiatric care experience, knowledge of DSM‑V, and strong analytical plus computer skills; coordination with admissions and business office is essential

Qualifications

• Bachelor's prepared healthcare professional (Counseling, Psychology, or Social Work) required or RN with direct experience. Masters preferred.
• Valid RN license, LCSW, or LPC preferred.
• A minimum of 3-5 years direct psychiatric patient care experience.
• Must possess knowledge of psychiatric care, utilization review, insurance reimbursement procedures, DSM-V, etc.
• Advanced computer skills necessary. Strong analytical, organizational, verbal and written skills required.

Responsibilities

• Evaluate patient medical records to determine severity of illness and appropriateness of level of care; manage medical necessity.
• Serve as liaison for patients and hospital with insurance companies; negotiate and advocate for patient length of stay and level of care.
• Lead physician daily treatment team meetings; manage authorizations and reviews for outpatient programming; obtain precertifications at admission.
• Coordinate with business office and admissions to complete preliminary verification of benefits; understand levels of care offered and manage patient benefits.

Skills

Psychiatric care

Utilization review

Insurance reimbursement

DSM-V knowledge

Analytical skills

Computer skills

Education

Bachelor's prepared healthcare professional (Counseling, Psychology, or Social Work)

RN license, LCSW, or LPC preferred

Masters preferred

Job description

Centennial Peaks Hospital in Louisville, CO, part of Universal Health Services, provides psychiatric services including inpatient, electroconvulsive therapy, and outpatient programs. The Utilization Review Coordinator assesses medical necessity and negotiates care with insurers within a multidisciplinary team.

The role requires 3–5 years of psychiatric care experience, knowledge of DSM‑V, and strong analytical plus computer skills; coordination with admissions and business office is essential