Utilization Review Specialist

Lifepoint Health; Olathe (KS); Hybrid; USD 60,000 - 80,000; Full time

Benefits offered by this job

Health insurance

Flexible spending accounts

Health savings account

Dental insurance

Paid time off

Disability insurance

Tuition reimbursement

401(k) matching

Employee assistance program

Professional development

Job summary

Cottonwood Springs, part of Lifepoint Health, seeks an experienced Utilization Review Specialist in Olathe, KS. You will review admissions and ongoing stays, analyze records, and collaborate with payers to ensure appropriate care levels.

Responsibilities include advocating for patients with behavioral health needs and guiding discharge planning in coordination with the treatment team. Strong emphasis on licensure and certifications.

Qualifications

• Bachelor's degree required; Master's preferred.
• Experience in utilization review in psychiatric healthcare preferred.
• Current unencumbered clinical license preferred.
• CPR certification and CPI training preferred.

Responsibilities

• Facilitates clinical reviews on patient admissions and continue stays.
• Analyzes patient records to determine legitimacy of admission, treatment, and length of stay.
• Interfaces with managed care organizations, external reviewers, and other payers.
• Advocates for patients with substance abuse or psychiatric disorders to manage care providers.
• Assists the treatment team with insurance requirements for continued stay and discharge planning.

Skills

Utilization Review Experience

CPR Certification

CPI Training

Clinical License

Education

Bachelor's degree

Master's degree

Job description

Your experience matters

At Cottonwood Springs, we are committed to empowering and supporting a diverse and determined workforce who can drive quality, scalability, and significant impact across our hospitals and communities. In your role, you'll support those that are in our facilities who are interfacing and providing care to our patients and community members. We believe that our collective efforts will shape a healthier future for the communities we serve.

How you'll contribute

Utilization Review Specialist facilitates clinical reviews on all patient admissions and continued stays. UR analyzes patient records to determine legitimacy of admission, treatment, and length of stay and interfaces with managed care organizations, external reviewers, and other payers. UR advocates on behalf of patients with substance abuse, dual diagnosis, psychiatric or emotional disorders to manage care providers for necessary treatment. UR contacts external case managers/managed care organizations for certification of insurance benefits throughout the patient's stay and assists the treatment team in understanding the insurance company's requirements for continued stay and discharge planning.

What we offer

Fundamental to providing great care is supporting and rewarding our team. In addition to your base compensation, this position also offers:

• Comprehensive medical, dental, and vision plans, plus flexible-spending and health- savings accounts


• Competitive paid time off


• Income-protection programs, such as life, accident, critical-injury insurance, short- and long-term disability, and identity theft coverage


• Tuition reimbursement, loan assistance, and 401(k) matching


• Employee assistance program including mental, physical, and financial wellness


• Professional development and growth opportunities

Qualifications and requirements

• Bachelor's degree required. Master's degree preferred.


• Previous utilization review experience in a psychiatric healthcare facility preferred.


• License: Current unencumbered clinical license preferred.


• Additional Requirements: CPR certification and Crisis Prevention Training (CPI) preferred. May be required to work flexible hours and overtime.

About Us

Cottonwood Springs is a 108 - bed hospital located in Olathe, KS, and is part of Lifepoint Health, a diversified healthcare delivery network committed to making communities healthier with acute care, rehabilitation, and behavioral health facilities from coast to coast. From your first day to your next career milestone-your experience matters

EEOC Statement

Cottonwood Springsis an Equal Opportunity Employer. Cottonwood Springsis committed to Equal Employment Opportunity for all applicants and employees and complies with all applicable laws prohibiting discrimination and harassment in employment.

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 additional sites of care across the healthcare continuum, such as acute rehabilitation units, outpatient centers and post-acute care facilities. We believe that success is achieved through talented people. We want to create places where employees want to work, with opportunities to pursue meaningful and satisfying careers that truly make a difference in communities across the country.