Personalized mental health treatment for teens, young adults & families in crisis.
Utilization Review Specialist
Location
United States
Posted
2 days ago
Salary
$53K - $65K / year
Seniority
Mid Level
Job Description
Utilization Review Specialist
Charlie Health
• Oversees all functions of a virtual IOP caseload • Collaborates at a high level to problem solve on complex cases with Manager • Completes pre-certs and authorizations for virtual IOP clients in a timely manner • Follows up on all outstanding authorizations and reports all barriers to Manager • Collaborates with Revenue Cycle Team and Admissions to improve patient experience from the front door through discharge • Partners with Manager and Director to troubleshoot workflows and processes to achieve efficiency gains in current and future company systems • Delivers training to clinical teams for high quality documentation standardization • Participate in denial management, appeals, and peer-to-peer review processes
Job Requirements
- High School Diploma
- 2+ years of experience in a utilization role within the utilization review field required
- Google proficiency
- Strong interpersonal, relationship-building and listening skills, with a natural, consultative style
- Ability to energize, communicate, and build rapport at all levels within an organization
- Strong project management skills, with a demonstrable ability to corral and manage details in a fast-paced, fluid environment
- Experience advising, presenting to, and persuading senior corporate personnel
- Knowledge of utilization review processes, medical necessity criteria, and healthcare regulations
- Familiarity with InterQual, MCG, or similar clinical guidelines
- Strong analytical, communication, and documentation skills
- Proficiency with electronic medical records (EMR) and utilization management systems
- Understanding of HIPAA and patient confidentiality requirements.
Benefits
- Charlie Health is pleased to offer comprehensive benefits to all full-time, exempt employees. Read more about our benefits here.
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