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Utilization Review Specialist
$73k-103k (estimate)
Full Time 4 Months Ago
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Charlie Health Strategy & Operations is Hiring a Remote Utilization Review Specialist

About the Role

The purpose of this position is to ensure that the utilization process is thorough, organized and streamlined to provide the best possible length of stays for our patients. Given the complex nature of insurance these days, it is crucial to have timely communication with these payors so that families can focus on what’s important, getting their loved ones the care they need.

Our team is comprised of passionate, forward-thinking professionals eager to take on the challenge of the mental health crisis and play a formative role in providing life-saving solutions. We are looking for a candidate who is inspired by our mission and excited by the opportunity to build a business that will impact millions of lives in a profound way.

Responsibilities

  • Oversees all functions of a virtual IOP caseload 
  • Completes peer reviews on cases with insurance
  • Collaborates at a high level to problem solve on complex cases with Manager
  • Completes pre-certs and continued stay authorizations for virtual IOP clients in a timely manner
  • Follows up on all outstanding authorizations and reports all barriers to Manager
  • Collaborates with Revenue 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 frequent training to clinical teams for high quality documentation standardization
  • Consulting across teams, providing mentorship, and contributing specialized knowledge

Requirements

  • Master’s Degree in healthcare field preferred 
  • 2 years of experience in a utilization role within the healthcare field required
  • Microsoft Office and Salesforce 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 all confidentially requirements regarding patients and strict maintenance of proper confidentiality on all such information.
  • Excellent written and verbal communication skills 
  • Organizational skills 
  • Ability to maintain a high level of integrity and confidentiality of medical information 
  • Strict attention to details

Benefits

Charlie Health is pleased to offer comprehensive benefits to all full-time, exempt employees. Read more about our benefits here.

Additional Information

Note to Colorado applicants: applications will be accepted and reviewed on a rolling basis

The expected base pay for this role will be between $63,000 and $98,640 per year at the commencement of employment. However, base pay will be determined on an individualized basis and will be impacted by location and years of experience. Further, base pay is only part of the total compensation package, which, depending on the position, may also include incentive compensation, discretionary bonuses, other short and long-term incentive packages, and other Charlie Health-sponsored benefits. #LI-Remote

Job Summary

JOB TYPE

Full Time

SALARY

$73k-103k (estimate)

POST DATE

01/05/2024

EXPIRATION DATE

05/29/2024

Show more

Charlie Health Strategy & Operations
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$44k-55k (estimate)
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The job skills required for Utilization Review Specialist include Mental Health, Confidentiality, Microsoft Office, Verbal Communication, etc. Having related job skills and expertise will give you an advantage when applying to be an Utilization Review Specialist. That makes you unique and can impact how much salary you can get paid. Below are job openings related to skills required by Utilization Review Specialist. Select any job title you are interested in and start to search job requirements.

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The following is the career advancement route for Utilization Review Specialist positions, which can be used as a reference in future career path planning. As an Utilization Review Specialist, it can be promoted into senior positions as an Utilization Review Manager - Home Care that are expected to handle more key tasks, people in this role will get a higher salary paid than an ordinary Utilization Review Specialist. You can explore the career advancement for an Utilization Review Specialist below and select your interested title to get hiring information.

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If you are interested in becoming an Utilization Review Specialist, you need to understand the job requirements and the detailed related responsibilities. Of course, a good educational background and an applicable major will also help in job hunting. Below are some tips on how to become an Utilization Review Specialist for your reference.

Step 1: Understand the job description and responsibilities of an Accountant.

Quotes from people on Utilization Review Specialist job description and responsibilities

Utilization Review Specialists ensure that Doctors and Nurses choose only the best treatments for them.

03/11/2022: Fort Myers, FL

Utilization review typically refers to the review of services that have already been delivered, while utilization management often refers to the review of coverage for future medical services.

02/16/2022: Louisville, KY

Assess plans for patient care and determine what treatment is appropriate and most cost-effective

02/15/2022: Augusta, GA

Analyze electronic medical records, and inform medical staff whether a medical claim is denied,

03/11/2022: Boston, MA

Prepares and submits regular reports on utilization control and on review activities.

02/26/2022: Reading, PA

Step 2: Knowing the best tips for becoming an Accountant can help you explore the needs of the position and prepare for the job-related knowledge well ahead of time.

Career tips from people on Utilization Review Specialist jobs

Know where to find utilization review jobs.

03/13/2022: Clarksville, TN

Create a utilization review cover letter.

02/18/2022: Reno, NV

Sign up for free credit monitoring.

03/16/2022: New London, CT

Set up documentation shortcuts.

03/05/2022: Lawton, OK

Take the certification examination.

05/08/2022: New Bedford, MA

Step 3: View the best colleges and universities for Utilization Review Specialist.

Butler University
Carroll College
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High Point University
Princeton University
Providence College
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