Utilization Review Specialist

River Valley Behavioral Health; Owensboro (KY); On-site; USD 33,000 - 42,000; Full time

Benefits offered by this job

Competitive pay

Health, dental, vision, Telehealth

9 paid holidays

Retirement plan options

Tuition reimbursement and free CEUs

Clinical supervision and development

Wellness and EAP programs

Mileage reimbursement for work travel

PSLF eligible employer

Job summary

Paycom in Owensboro, KY is seeking a Full Time Utilization Review role to verify benefits and support a care team. The position requires a High School/GED with experience in mental health utilization review, or a Bachelor’s in a related field, or KY LPN/RN license. Strong organizational and communication skills are essential.

The role emphasizes data reporting, collaboration with UR and management teams, and attendance at treatment team meetings as needed. Local eligibility and duties will apply.

Qualifications

• High School/GED with two years of mental health utilization review experience
• Bachelor’s degree in psychology, social work, or sociology
• KY LPN/RN license as alternative qualification

Responsibilities

• Verifies insurance benefits and relays that information to UR team and other parties.
• Participates in skill enhancement activities to improve utilization review processes.
• Attends treatment team meetings when necessary and supports the UR team.
• Provides data and reports to UR supervisor as requested.
• Provides backup for the UR Specialist or other UR staff as needed.
• Fosters collaborative working relationships among UR team members and management teams.
• Other duties as assigned by UR Supervisor

Skills

Office skills

Public interaction

Organizational skills

Basic computer skills

Education

High School/GED

Bachelor’s degree in psychology/social work/sociology

KY LPN/RN license

Job description

Job Details: Job Location: Owensboro, KY 42301, Position Type: Full Time, Education Level: High School/GED, Salary Range: $16.00 - $20.25 Hourly, Travel Percentage: None, Job Shift: Day

Why Join Our Team?

• Competitive pay
• Comprehensive health, dental, vision, and Telehealth benefits
• Paid time off plus 9 paid holidays
• Retirement plan options
• Tuition reimbursement and free CEUs
• Clinical supervision and professional development
• Wellness and Employee Assistance Programs
• Mileage reimbursement for work-related travel
• Public Service Loan Forgiveness (PSLF) eligible employer

Essential Functions:

• Verifies insurance benefits and relays that information to appropriate parties.
• Participates in skill enhancement activities.
• Participants in treatment team meetings when necessary.
• Provides data and reports to UR supervisor as requested.
• Provides backup for the UR Specialist or other UR staff as needed.
• Fosters collaborative working relationships among members of the UR team, programs providing UR services for, and management teams.
• Other duties as assigned by UR Supervisor

Qualifications: Education and Experience:

• High School/GED AND Two (2) years’ experience working in mental health utilization review (or equivalent)
• OR
• Bachelor’s Degree in human services-related field (Psychology, Social Work, Sociology)
• OR
• KY LPN/RN License

Knowledge and Skills:

• Good knowledge of general office practices.
• Ability to deal effectively with the public.
• Good organizational skills.
• Basic computer skills preferred.