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Title

Utilization Review Specialist 

About the Organization CenterPointe Hospitals and Signature Psychiatric Hospitals are premier providers of behavioral health care services, delivered with compassion for patients and their families, respect for employees, physicians and other health professionals, accountability for clinical and ethical performance, and responsibility to the communities we serve. We are free-standing acute psychiatric hospitals with locations in St. Charles, Columbia, Kansas City and Liberty, Missouri.



Treatment is based on the belief that, through a combination of medically managed care and therapeutic intervention and education, patients can learn to effectively manage their illnesses and cope with the effects on their lives.

 
Location CenterPointe Hospital Columbia  
Full-Time/Part-Time Full-Time  
Exempt/Non-Exempt Exempt  
Shift Days  
Position Utilization Review Specialist I (LPN)  
Description

CenterPointe Hospital is hiring for a Utilization Review Specialist who also has experience working with denials and appeals. The Utilization Review Specialist has responsibility for ensuring the proper utilization of hospital resources for patients admitted to the hospital. This position is responsible for the management, review and monitoring of the utilization of limited resources related to the patient. Also monitors the effectiveness of care by evaluating clinical appropriateness, reviewing with payor sources, receiving authorization for the type/volume of services through all levels of care and reviewing aftercare. Utilization of hospital resources is reflective of the needs of people diagnosed with a mental disorder, whose care needs can be met at various levels in the continuum of care.

 
Position Requirements

QUALIFICATIONS

Education: Graduate of an accredited college; master's degree in Social Work or other related mental health field; minimum of Associate's Degree in nursing, if LPN.
Experience: Previous direct clinical experience in a psychiatric or mental health setting. Knowledge of managed care and other insurance carrier regulations required.
License: Licensed to practice as an LPN or a Master's Level Clinician-license eligible (UR Specialist I).
Additional Requirements: CPR certification and Crisis Prevention (CPI) during orientation and prior to assisting in a restraining procedure. May be required to work flexible hours and overtime.

SKILLS:
• Ability to communicate in English, both verbally and in writing.
• Strong interpersonal skills.
• Knowledge of a wide range of psychosocial, cognitive and/or developmental disorders.
• Basic computer knowledge.
• Working knowledge of managed care/insurance requirements.

 
EOE Statement We are an equal employment opportunity employer. All qualified applicants will receive consideration for employment without regard to race, color, religion, gender, national origin, disability status, protected veteran status or any other characteristic protected by law.  
Req Number SOC-20-00004  

This position is currently not accepting applications.

To search for an open position, please go to http://CenterPointeHospital.appone.com



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