Utilization Review Specialist

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. Responsibilities include overseeing all functions of a virtual IOP caseload, completing peer reviews, collaborating to problem solve, completing pre-certs and continued stay authorizations, following up on outstanding authorizations, and partnering with the Revenue Team and Admissions to improve patient experience. The role also delivers frequent training to clinical teams for high quality documentation standardization and contributes specialized knowledge across teams.