Psychiatric Utilization Review Specialist

Lifepoint Health®; Tucson (AZ); On-site; USD 70,000 - 90,000; Full time

Benefits offered by this job

Medical, dental & vision

Life & disability insurance

Paid family leave & PTO

Tuition assistance

Loan assistance

401(k) with company match

Mental health programs

Career development

Job summary

Lifepoint Health invites applications for a Utilization Review Specialist at El Dorado Springs Behavioral Health. This role supports admissions reviews, treatment authorization, and discharge planning within our psychiatric care setting.

You will collaborate with the care team and payers to ensure appropriate access to services, complete pre-certifications, and communicate denials. A Bachelor's degree is required; a Master's is preferred.

Qualifications

• Bachelor's degree is required; Master's degree preferred.
• Current unencumbered clinical license strongly preferred.
• CPR certification and CPI training preferred.
• Previous utilization review experience in a psychiatric facility preferred.

Responsibilities

• Facilitates clinical reviews for patient admissions and continued stays.
• Analyzes patient records to determine admission appropriateness and length of stay; interfaces with payers.
• Advocates for access to necessary treatment with managed care providers.
• Completes pre-certifications and re-certifications; reports denials and authorization information.
• Interacts with interdisciplinary team to obtain authorization information.
• Schedules peer-to-peer reviews with physicians; communicates denials accurately.

Skills

Utilization review

Education

Bachelor's degree

Master's degree preferred

Job description

Lifepoint Health invites applications for a Utilization Review Specialist at El Dorado Springs Behavioral Health. This role supports admissions reviews, treatment authorization, and discharge planning within our psychiatric care setting.

You will collaborate with the care team and payers to ensure appropriate access to services, complete pre-certifications, and communicate denials. A Bachelor's degree is required; a Master's is preferred.