Utilization Review Specialist

KVC Health Systems • Wichita, KS

22h • $0 - $18 • Hybrid

About The Position

The Utilization Review department manages all aspects of a patient’s stay related to initial authorization, concurrent reviews and discharge coordination with health plans. The UR Specialist serves as the primary contact with insurance providers and works closely with admissions, physicians, nurses, therapists and treatment teams to ensure timely, accurate and complete assessments and service coordination for children and youth. This position requires exceptional attention to detail, organization and communication skills in a fast-paced healthcare environment focused on quality care and compliance.

Requirements

• High school diploma or GED required
• Valid driver’s license
• Current auto insurance
• Minimum two years of experience in case management, utilization review, or wellness coordination
• At least one year working with economically disadvantaged, vulnerable or at-risk youth and/or adults

Nice To Haves

• Bachelor’s degree in a human services field preferred, including Social Work, Education, Sociology, Psychology, Counseling, Applied Behavioral Sciences, or Criminal Justice
• Intermediate Microsoft Office Suite skills including Word, Excel and Outlook
• Strong verbal and written communication skills
• Excellent organizational and interpersonal abilities
• Ability to manage detailed work in a fast-paced environment

Responsibilities

• Coordinate communication with health plans and insurance companies
• Review and manage authorizations and child-specific contracts
• Ensure accurate documentation within electronic health records
• Compile, summarize and enter clinical and assessment information
• Assist with intake assessments and discharge summaries
• Support admissions paperwork and utilization review functions
• Prepare reports, forms and appeals for insurance providers
• Conduct documentation reviews to ensure compliance and quality standards
• Assist with audits, quality assurance initiatives and special projects
• Maintain strict confidentiality of child, youth and family information
• Collaborate with internal teams, referral sources and community partners

Benefits

• Mission-driven work supporting children and families
• Collaborative and inclusive workplace culture
• Professional development and ongoing training opportunities
• Hybrid work flexibility after successful onboarding period
• Monday–Friday schedule with consistent daytime hours
• Opportunity to work alongside multidisciplinary healthcare teams
• Meaningful career growth in behavioral health services

What This Job Offers

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