Utilization Review Specialist - Behavioral Health

Clive Behavioral; Raleigh (NC); On-site; USD 65,000 - 90,000; Full time

Benefits offered by this job

Competitive salary

Paid time off

Medical plan

Loan forgiveness

Tuition reimbursement

401(k) plan

Career development

Job summary

Universal Health Services, Inc. is seeking a Utilization Management professional to coordinate and monitor services for inpatients and outpatients. The role requires RN licensure or a Behavioral Health master’s degree, with at least one year in hospital utilization management.

Knowledge of behavioral managed care and clinical assessment is essential. The position supports a hospital setting with responsibilities including admission/discharge review, third-party payor communications, and

Qualifications

• Bachelor degree in Nursing, Counseling, Psychology or Social Work; Masters preferred.
• One year experience in Utilization Management in a hospital setting.
• Knowledge in behavioral managed care and clinical assessment to align patient acuity with care guidelines.

Responsibilities

• Coordinate utilization and documentation for inpatients and outpatients.
• Review admission, continued stay, and discharge planning.
• Support quality patient care through review and evaluation of clinical practices.

Skills

DSM methodology

Telephone etiquette

Communication skills

Medical terminology

Documentation

Time management

Team collaboration

Education

Bachelor's degree in Nursing

Bachelor's degree in Behavioral Health

Masters degree preferred

Job description

Universal Health Services, Inc. is seeking a Utilization Management professional to coordinate and monitor services for inpatients and outpatients. The role requires RN licensure or a Behavioral Health master’s degree, with at least one year in hospital utilization management.

Knowledge of behavioral managed care and clinical assessment is essential. The position supports a hospital setting with responsibilities including admission/discharge review, third-party payor communications, and