What are the responsibilities and job description for the Utilization Review Specialist | Partial Hospitalization Program position at LENAPE VALLEY FOUNDATION?
Join Our Team
Make a meaningful impact behind the scenes of behavioral healthcare. Lenape Valley Foundation is seeking a Utilization Review Specialist to support our growing Partial Hospitalization Program (PHP). This newly created role serves as the bridge between our clinical team and insurance providers, ensuring clients receive timely access to medically necessary treatment while supporting efficient program operations. As a key member of our interdisciplinary team, you will oversee insurance authorizations, utilization review activities, outcome tracking, and care coordination while helping patients access the services they need. The hours for this position are Monday-Friday 8:30 am – 3:30 pm.
What We Offer
- DailyPay- gives you the flexibility to access your earnings immediately- on your own schedule!
- Paid training and supervision
- 403(b) Retirement Plan
- FULL TIME Benefits Package Includes:
- Generous PTO Policy
- 15 PTO Days, 10 Paid Sick Days, 4 Paid Personal Days, 7 Paid Holidays, 5 Paid Conference Days
- Medical, Dental, and Vision Insurance
- Credit available for medical opt-out
- Flexible Spending Account (FSA)
- Long-Term Disability and Basic Life Insurance
- Employee Assistance Program (EAP)
- Continuing Education Assistance Program
- Access to student loan management and repayment support
- Generous PTO Policy
What You Bring
- Bachelor’s degree in human services, Psychology, Social Work, Sociology, or related field preferred
- Strong computer skills: EHR experience preferred
- Strong verbal and written communication skills
- Ability to meet the physical demands of the role, with or without accommodation
Your Role
- Manage insurance authorizations for PHP clients, including initial, concurrent, and continued-stay requests
- Serve as the primary contact with insurance companies and utilization management departments
- Review clinical information and submit documentation supporting medical necessity
- Monitor authorization deadlines, approvals, denials, and requests for additional information
- Coordinate with the treatment team on continued stays, discharge planning, and care transitions
- Run daily PROMIS assessments and track program outcomes
- Assist with referrals to outpatient services and community resources
- Maintain accurate documentation and authorization records within the EHR
- Help identify opportunities to reduce denials and improve program efficiency
- Perform other duties as assigned
About Lenape Valley Foundation
Since 1958, Lenape Valley Foundation (LVF) has been a trusted non-profit provider of essential human services in Bucks and Montgomery Counties. Our mission is to partner with individuals facing mental health, substance use, or developmental challenges as they pursue personal goals and improved quality of life. With over 30 programs and a commitment to evidence-based care, LVF continues to evolve to meet community needs.
Our Commitment To Diversity and Inclusion
LVF is an Equal Opportunity Employer. We are committed to fostering a workplace that respects and celebrates diversity. We welcome applicants of all backgrounds and ensure a discrimination and harassment free environment where everyone is treated with dignity.