UTILIZATION REV SPEC I

Position Summary

In this role, you will coordinate and manage insurance utilization review activities for hospitalized clients. You'll work closely with clinical teams, insurance representatives, and internal departments to ensure timely authorizations, support treatment planning, and contribute to high-quality patient outcomes.

Key Responsibilities

• Partner daily with the Access Center and/or Crisis Response Center (CRC) to identify clients needing utilization review
• Communicate clinical information to insurance reviewers to secure authorizations and extended lengths of stay
• Collaborate with attending psychiatrists on clinical assessments and treatment recommendations
• Participate in interdisciplinary treatment team meetings to support care for managed care clients
• Provide constructive clinical feedback to enhance service delivery and patient care
• Ensure accurate authorization details are submitted to Patient Accounts for billing
• Review client charts for potential denial issues and support appeal processes when needed
• Maintain strict adherence to ethical standards, confidentiality, and organizational policies

Qualifications

Required:

• High School Diploma or equivalent
• Level II Background clearance (Aspire covers fingerprinting costs)
• Valid driver's license with an acceptable driving record per organizational guidelines

Preferred:

• Experience in behavioral health, utilization review, or managed care environments
• LPN or RN experience
• Strong communication, documentation, and organizational skills

Why Join Aspire?

• Mission-driven organization making a real impact in your community
• Collaborative, team-focused work environment
• Opportunities for growth and professional development
• A role where your work directly supports quality care and patient outcomes