Utilization Review Specialist (URS)

About the role

Triangle Springs, part of Lifepoint Behavioral Health, is seeking passionate, patient-centric, and goal-oriented team members to join our compassionate behavioral health services team. We specialize in crisis stabilization, inpatient care, and outpatient treatment for acute mental health and substance use treatment.

Responsibilities

• Displays knowledge of clinical criteria, managed care requirements for inpatient and outpatient authorization and advocates on behalf of the patient to secure coverage for needed services.
• Reports appropriate denial, and authorization information to designated resource.
• Works with DON to ensure documentation requirements are met.
• Interface with managed care organizations, external reviews, and other payers.
• Other duties as assigned.

Qualifications

• Bachelor’s degree required.
• Master’s degree preferred.
• Previous utilization review experience in a psychiatric healthcare facility preferred.
• Current unencumbered clinical license strongly preferred.
• CPR certification and Crisis Prevention Training (CPI) preferred.

Benefits

• Affordable medical, dental and vision plans provided to meet the needs of full employees and their families.
• Up to 16 days of PTO for full time employees.
• 6 paid holidays for full time employees.
• Tuition reimbursement.
• 401(k) retirement plan.
• Flexible spending and health savings accounts.
• UKG Wallet - We've partnered with UKG Wallet, a voluntary Earned Wage Access benefit, to offer employees access to their pay on their own schedule.