Competitive salary commensurate with experience + ...
Utilization review and management
Insurance authorization coordination
Appeal process management
The Utilization Specialist is responsible for reviewing admissions, continued stays, and discharge planning according to approved clinically valid criteria
Job Summary
The Utilization Specialist is responsible for reviewing admissions, continued stays, and discharge planning according to approved clinically valid criteria.
This role involves coordinating with insurance companies and health maintenance organizations to secure approvals for inpatient treatment days.
Palms Behavioral Health offers a comprehensive benefit plan and a competitive salary commensurate with experience and qualifications.
Matching Summary
The Utilization Specialist is responsible for reviewing admissions, continued stays, and discharge planning according to approved clinically valid criteria.
Salary
Competitive salary commensurate with experience and qualifications; Comprehensive benefit plan included
Skills & Requirements
Must-have
Utilization review and management
Insurance authorization coordination
Appeal process management
Clinical criteria application
Physician communication
Nice-to-have
Statistical reporting skills
Peer review facilitation
Quality improvement initiatives
Staff training experience
Multi-disciplinary collaboration
Key Requirements
Bachelor's degree in social work or related health field
Two or more years of direct clinical experience in psychiatric setting
Current licensure as LPN, RN, or clinical professional license
Graduation from an approved/accredited school of nursing