Utilization Review Specialist

Cottonwood Springs; Olathe (KS); On-site; USD 55,000 - 75,000; Full time

Benefits offered by this job

Medical, dental, vision plans

Paid time off

Disability and life insurance

Tuition reimbursement

401(k) matching

Employee assistance program (EAP)

Professional development

Job summary

Cottonwood Springs Hospital in Olathe, KS, is seeking a dedicated Utilization Review Specialist to scrutinize patient admissions and stay lengths. You will interface with managed care orgs and external reviewers while advocating for appropriate treatment plans across diverse patient populations.

The role requires collaboration with care teams, review of medical records for admission legitimacy, length of stay, and insurance benefits, and the ability to ensure compliant discharge planning

Qualifications

• Bachelor's degree required; Master's degree preferred.
• Experience in utilization review in a psychiatric healthcare facility preferred.
• Current unencumbered clinical license preferred.
• CPR certification and CPI training preferred. May be required to work flexible hours and overtime.

Responsibilities

• 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.

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.

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 Springs is an Equal Opportunity Employer. Cottonwood Springs is 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.