Utilization Review Specialist (UR), Behavioral Health

Lifepoint Health•West Chester, OH

3d•Onsite

About The Position

Beckett Springs is part of Lifepoint Health, a diversified healthcare delivery network with facilities coast to coast. We are driven by a profound commitment to prioritize your well-being so you can provide exceptional care to others. As a Utilization Review Specialist joining our team, you’re embracing a vital mission dedicated to making communities healthier ® . Join us on this meaningful journey where your skills, compassion and dedication will make a remarkable difference in the lives of those we serve.

Requirements

Bachelor’s Degree
Current unencumbered clinical license strongly preferred
CPR certification and Crisis Prevention Training (CPI) preferred
May be required to work flexible hours and overtime

Nice To Haves

Master’s degree preferred
Previous utilization review experience in a psychiatric healthcare facility preferred

Responsibilities

Displays knowledge of clinical criteria, managed care requirements for inpatient and outpatient authorization and advocates on behalf of the patient to secure coverage for needed services
Completes pre and re-certifications for inpatient and outpatient services.
Reports appropriate denial, and authorization information to designated resource.
Actively communicates with interdisciplinary team to acquire pertinent information and give updates on authorizations.
Participate in treatment teams to ensure staff have knowledge of coverage and to collect information for communication with agencies.
Works with DON to ensure documentation requirements are met.
Ensure appeals are completed thoroughly and on a timely basis.