Utilization Review Specialist
About the role
Your Experience Matters At Cottonwood Springs, we are committed to empowering and supporting a diverse and determined workforce who can drive quality, scalability, and significant impact across our hospitals and communities. In your role, you'll support those that are in our facilities who are interfacing and providing care to our patients and community members. We believe that our collective efforts will shape a healthier future for the communities we serve. Cottonwood Springs is a 108‑bed hospital located in Olathe, KS, and is part of Lifepoint Health, a diversified healthcare delivery network committed to making communities healthier® with acute care, rehabilitation, and behavioral health facilities from coast to coast.
Responsibilities
Utilization Review Specialist facilitates clinical reviews on all patient admissions and continued stays. UR analyzes patient records to determine legitimacy of admission, treatment, and length of stay and interfaces with managed care organizations, external reviewers, and other payers. UR advocates on behalf of patients with substance abuse, dual diagnosis, psychiatric or emotional disorders to manage care providers for necessary treatment. UR contacts external case managers/managed care organizations for certification of insurance benefits throughout the patient's stay and assists the treatment team in understanding the insurance company's requirements for continued stay and discharge planning.
Benefits
- Comprehensive medical, dental, and vision plans, plus flexible‑spending and health‑savings accounts
- Competitive paid time off
- Income‑protection programs, such as life, accident, critical‑injury insurance, short‑ and long‑term disability, and identity theft coverage
- Tuition reimbursement, loan assistance, and 401(k) matching
- Employee assistance program including mental, physical, and financial wellness
- Professional development and growth opportunities
Qualifications
- Bachelor's degree required
- Master's degree preferred
- Previous utilization review experience in a psychiatric healthcare facility preferred
- Current unencumbered clinical license preferred
- CPR certification preferred
- Crisis Prevention Training (CPI) preferred
Schedule
May be required to work flexible hours and overtime.