PRN Utilization Review Specialist - Behavioral Health

Your experience matters

Collin Springs-Changes Plano is part of Lifepoint Health, a diversified healthcare delivery network with facilities coast to coast. We are driven by a profound commitment to prioritize your well-being so you can provide exceptional care to others. As a Utilization Review Specialist joining our team, you're embracing a vital mission dedicated to making communities healthier®. Join us on this meaningful journey where your skills, compassion and dedication will make a remarkable difference in the lives of those we serve.

How you'll contribute

An Utilization Review Specialistwho excels in this role:

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

Completes pre and re-certifications for inpatient and outpatient services.

Reports appropriate denial, and authorization information to designated resource.

Actively communicates with interdisciplinary team to acquire pertinent information and give updates on authorizations.

Participate in treatment teams to ensure staff have knowledge of coverage and to collect information for communication with agencies.

Works with DON to ensure documentation requirements are met.

Ensure appeals are completed thoroughly and on a timely basis.

Interface with managed care organizations, external reviews, and other payers.

Communicate with physicians to schedule peer to peer reviews.

Accurately report denials. Why join us

We believe that investing in our employees is the first step to providing excellent patient care. In addition to your base compensation, this position also offers:

Working with a highly engaged staff

Healthy staffing levels

Flexible scheduling

Career growth

Competitive compensation What we're looking for

Applicants should have a Bachelor's degree (required), Master's degree preferred. Additional requirements include:

Current unencumbered clinical license strongly preferred

CPR and CPI Certification within 30 day of employment

Previous utilization review experience in a psychiatric healthcare facility preferred.

More about Collin Springs

Colling Springs is a 72-bed behavioral health hospital offering exceptional care to the McKinney, TX community.

EEOC Statement

"Collin Springs is an Equal Opportunity Employer. Collin Springs is committed to Equal Employment Opportunity for all applicants and employees and complies with all applicable laws prohibiting discrimination and harassment in employment."

About Us

Lifepoint Health is a leader in community-based care and driven by a mission of Making Communities Healthier. Our diversified healthcare delivery network spans 29 states and includes 63 community hospital campuses, 32 rehabilitation and behavioral health hospitals, and more than 170 additional sites of care across the healthcare continuum, such as acute rehabilitation units, outpatient centers and post-acute care facilities. We believe that success is achieved through talented people. We want to create places where employees want to work, with opportunities to pursue meaningful and satisfying careers that truly make a difference in communities across the country.

About the Team

We employ and provide care to people from all walks of life. We are committed to promoting healing, providing hope, preserving dignity and producing value with an inclusive workforce in which diversity is leveraged, respected, and reflective of the patients, family members, customers and team members we serve.