Charlie Health logo
Charlie Health

Personalized mental health treatment for teens, young adults & families in crisis.

Utilization Review Specialist

GeneralGeneralFull TimeRemoteMid LevelTeam 501-1,000H1B No SponsorCompany SiteLinkedIn

Location

United States

Posted

2 days ago

Salary

$53K - $65K / year

Seniority

Mid Level

High School2 yrs expEnglish

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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