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SalaryPremier Health Group is a leading healthcare organization dedicated to providing high-quality mental health and substance abuse services to our community. We are committed to delivering compassionate and evidence-based care to improve the lives of those we serve. As part of our team, you will have the opportunity to make a meaningful impact on the well-being of individuals facing mental health and substance abuse challenges.
Job Summary
The Utilization Review Specialist with Mental Health and/or Substance Abuse Experience plays a vital role in ensuring that the services we provide are of the highest quality and meet the unique needs of our clients. This position involves evaluating clinical records and treatment plans to determine the appropriateness and necessity of services, ensuring that they align with best practices and regulatory requirements. The Utilization Review Specialist collaborates with our clinical teams and external partners to optimize the utilization of resources and improve the overall quality of care.
Key Responsibilities
- Clinical Record Review: Thoroughly review mental health and substance abuse clinical records.
- Utilization Determination: Evaluate treatment plans and services for compliance and necessity.
- Collaboration: Work closely with clinical staff and external partners.
- Quality Assurance: Monitor and recommend improvements to enhance care.
- Documentation: Maintain accurate Utilization Review records.
- Compliance: Stay updated on industry regulations.
- Reporting: Communicate findings through reports.
- Training: Provide guidance and training to clinical staff.
Qualifications
- Utilization review experience in mental health/substance abuse.
- Strong knowledge of related treatment modalities.
- Familiarity with insurance and regulatory standards.
- Excellent communication and analytical skills.
Compensation: $65,000-$75,000, Depending on experience
Benefits: 401(k) with company match, Medical, Dental, Vision, Gym Access (right across the street!)
Job Type: Full-time
Pay: $65,000.00 - $75,000.00 per year
Schedule:
- Day shift
- Monday to Friday
Work Location: In person
