Behavioral Health Social Worker, Utilization Review, Days (onsite)

Kindred Healthcare • Palestine, TX

32d • Onsite

About The Position

Palestine Regional Medical Center in Palestine, TX, a 150-bed hospital, is seeking a Behavioral Health Social Worker for Utilization Review. This role ensures appropriate use of hospital services, admissions, and extended stays by monitoring adherence to the utilization review plan. The Social Worker-Utilization Review performs pre-certification, concurrent review, and discharge planning in accordance with applicable guidelines, acting as a liaison to support safe, timely, and medically necessary care. Palestine Regional is an integral part of the local community, offering a chance to grow your career while making a real impact close to home.

Requirements

• Bachelor of Social Work degree from an accredited school of social work (Required)
• Licensed in the state of practice as LBSW, LMSW, or LCSW.
• License must be current and without restrictions.
• Strong clinical assessment and critical thinking skills
• Ability to interpret medical records, criteria, and regulations
• Knowledge of utilization review processes, discharge planning, and payer requirements
• Proficient in communication and coordination with interdisciplinary teams
• Skilled in documentation, confidentiality practices, and health information systems
• Demonstrates resilience, adaptability, and the ability to manage stress effectively
• Frequent use of computers and telephone
• Must be able to sit or stand for prolonged periods
• Occasional lifting of up to 25 pounds
• Frequent walking and light movement required during audits or rounding

Nice To Haves

• Master of Social Work degree from an accredited school of social work (Preferred)
• Two (2) years of progressive clinical experience preferred
• Psychiatric healthcare experience desirable

Responsibilities

• Ensures the medical necessity and appropriateness of all hospital admissions per established criteria
• Performs concurrent medical record reviews to justify continued stay and documents appropriately
• Coordinates with care team to facilitate timely and effective discharge planning
• Communicates with third-party payers and managed care entities to provide required documentation
• Collaborates with social services and case management to streamline patient transitions and reduce readmissions
• Reviews and monitors patient charts in alignment with medical staff performance improvement metrics
• Contributes to organizational quality goals and achieves performance targets in a timely manner

What This Job Offers

• Job Type: Full-time
• Career Level: Mid Level