Licensed Utilization Review Specialist

Job Summary

A company is looking for a Utilization Review Specialist to perform various utilization management-related reviews and ensure proper authorization for client care.

Key Responsibilities

• Perform pre-authorization, concurrent, and retrospective reviews for inpatient/outpatient services
• Act as a liaison between treatment team members using clinical expertise and payor knowledge
• Maintain required documentation in information systems and participate in case conferences and educational opportunities

Required Qualifications

• Master's degree in counseling (LPC, LCSW, LMFT) or BSN in nursing; licensure preferred
• Experience in utilization review and managed care preferred
• Experience in eating disorders preferred
• Familiarity with KIPU and other EMR systems
• Excellent time management and computer skills