ONSITE ONLY San Jose Behavioral Health is currently seeking a Utilization Review Specialist ... , LPC, LPC-I within the state where the facility provides services; or current clinical ...
ONSITE ONLY San Jose Behavioral Health is currently seeking a Utilization Review Specialist ... , LPC, LPC-I within the state where the facility provides services; or current clinical ...
Utilization Specialist - Full Time
San Jose, CA · On-site
$60/hr
The Utilization Review Specialist coordinates and assesses the inpatient census for appropriate ... , LPC, LPC-I within the state where the facility provides services; or current clinical ...
Utilization Specialist - Full Time
San Jose, CA · On-site
$60/hr
The Utilization Review Specialist coordinates and assesses the inpatient census for appropriate ... , LPC, LPC-I within the state where the facility provides services; or current clinical ...
The Utilization Review Specialist coordinates and assesses the inpatient census for appropriate ... , LPC, LPC-I within the state where the facility provides services; or current clinical ...
The Utilization Review Specialist coordinates and assesses the inpatient census for appropriate ... , LPC, LPC-I within the state where the facility provides services; or current clinical ...
Utilization Specialist PRN
$31 - $50/hr
Conduct reviews, in accordance with certification requirements, of insurance plans or other managed ... Preferred Licensure: LPN, RN, LMSW, LCSW, LPC, LPC-I within the state where the facility provides ...
Utilization Specialist PRN
$31 - $50/hr
Conduct reviews, in accordance with certification requirements, of insurance plans or other managed ... Preferred Licensure: LPN, RN, LMSW, LCSW, LPC, LPC-I within the state where the facility provides ...
Conduct reviews, in accordance with certification requirements, of insurance plans or other managed ... Preferred Licensure: LPN, RN, LMSW, LCSW, LPC, LPC-I within the state where the facility provides ...
Conduct reviews, in accordance with certification requirements, of insurance plans or other managed ... Preferred Licensure: LPN, RN, LMSW, LCSW, LPC, LPC-I within the state where the facility provides ...
Utilization Specialist PRN
Riverside, CA · On-site
$31 - $50/hr
Conduct reviews, in accordance with certification requirements, of insurance plans or other managed ... Preferred Licensure: LPN, RN, LMSW, LCSW, LPC, LPC-I within the state where the facility provides ...
Utilization Specialist PRN
Riverside, CA · On-site
$31 - $50/hr
Conduct reviews, in accordance with certification requirements, of insurance plans or other managed ... Preferred Licensure: LPN, RN, LMSW, LCSW, LPC, LPC-I within the state where the facility provides ...
Utilization Specialist PRN
Riverside, CA · On-site
$31 - $50/hr
Conduct reviews, in accordance with certification requirements, of insurance plans or other managed ... Preferred Licensure: LPN, RN, LMSW, LCSW, LPC, LPC-I within the state where the facility provides ...
Utilization Specialist PRN
Riverside, CA · On-site
$31 - $50/hr
Conduct reviews, in accordance with certification requirements, of insurance plans or other managed ... Preferred Licensure: LPN, RN, LMSW, LCSW, LPC, LPC-I within the state where the facility provides ...
Utilization Specialist Full-time
Riverside, CA · On-site
$31 - $50/hr
Conduct reviews, in accordance with certification requirements, of insurance plans or other managed ... Licenses/Designations/Certifications Preferred Licensure: LPN, RN, LMSW, LCSW, LPC, LPC-I within ...
Utilization Specialist Full-time
Riverside, CA · On-site
$31 - $50/hr
Conduct reviews, in accordance with certification requirements, of insurance plans or other managed ... Licenses/Designations/Certifications Preferred Licensure: LPN, RN, LMSW, LCSW, LPC, LPC-I within ...
Utilization Specialist - Full Time
Scotts Valley, CA · On-site
$25 - $27/hr
Conduct reviews, in accordance with certification requirements, of insurance plans or other managed ... Licenses/Designations/Certifications Preferred Licensure: LPN, RN, LMSW, LCSW, LPC, LPC-I within ...
Utilization Specialist - Full Time
Scotts Valley, CA · On-site
$25 - $27/hr
Conduct reviews, in accordance with certification requirements, of insurance plans or other managed ... Licenses/Designations/Certifications Preferred Licensure: LPN, RN, LMSW, LCSW, LPC, LPC-I within ...
Utilization Specialist Full-time
Riverside, CA · On-site
$31 - $50/hr
Conduct reviews, in accordance with certification requirements, of insurance plans or other managed ... Preferred Licensure: LPN, RN, LMSW, LCSW, LPC, LPC-I within the state where the facility provides ...
Utilization Specialist Full-time
Riverside, CA · On-site
$31 - $50/hr
Conduct reviews, in accordance with certification requirements, of insurance plans or other managed ... Preferred Licensure: LPN, RN, LMSW, LCSW, LPC, LPC-I within the state where the facility provides ...
Utilization Specialist Full-time
$31 - $50/hr
Conduct reviews, in accordance with certification requirements, of insurance plans or other managed ... Licenses/Designations/Certifications Preferred Licensure: LPN, RN, LMSW, LCSW, LPC, LPC-I within ...
Utilization Specialist Full-time
$31 - $50/hr
Conduct reviews, in accordance with certification requirements, of insurance plans or other managed ... Licenses/Designations/Certifications Preferred Licensure: LPN, RN, LMSW, LCSW, LPC, LPC-I within ...
Utilization Specialist - Full Time
Scotts Valley, CA · On-site
$25 - $27/hr
Conduct reviews, in accordance with certification requirements, of insurance plans or other managed ... Preferred Licensure: LPN, RN, LMSW, LCSW, LPC, LPC-I within the state where the facility provides ...
Utilization Specialist - Full Time
Scotts Valley, CA · On-site
$25 - $27/hr
Conduct reviews, in accordance with certification requirements, of insurance plans or other managed ... Preferred Licensure: LPN, RN, LMSW, LCSW, LPC, LPC-I within the state where the facility provides ...
Utilization Specialist - Full Time
Scotts Valley, CA · On-site
$25 - $27/hr
Conduct reviews, in accordance with certification requirements, of insurance plans or other managed ... Preferred Licensure: LPN, RN, LMSW, LCSW, LPC, LPC-I within the state where the facility provides ...
Utilization Specialist - Full Time
Scotts Valley, CA · On-site
$25 - $27/hr
Conduct reviews, in accordance with certification requirements, of insurance plans or other managed ... Preferred Licensure: LPN, RN, LMSW, LCSW, LPC, LPC-I within the state where the facility provides ...
Utilization Specialist - Full Time
Scotts Valley, CA · On-site
$25 - $27/hr
Conduct reviews, in accordance with certification requirements, of insurance plans or other managed ... Licenses/Designations/Certifications Preferred Licensure: LPN, RN, LMSW, LCSW, LPC, LPC-I within ...
Utilization Specialist - Full Time
Scotts Valley, CA · On-site
$25 - $27/hr
Conduct reviews, in accordance with certification requirements, of insurance plans or other managed ... Licenses/Designations/Certifications Preferred Licensure: LPN, RN, LMSW, LCSW, LPC, LPC-I within ...
Care Manager - BH
San Diego, CA · On-site
Authorizes and reviews utilization of mental health and substance abuse services provided in ... LPC, LCSW or RN Additional Information Requirements/Certifications: This is a Temp - to Perm ...
Care Manager - BH
San Diego, CA · On-site
Authorizes and reviews utilization of mental health and substance abuse services provided in ... LPC, LCSW or RN Additional Information Requirements/Certifications: This is a Temp - to Perm ...
BH Care Manager II - Utilization Management
$79K - $119K/yr
Refers cases to Peer Reviewers as appropriate. * Performs psychiatric and substance abuse or ... Current, active, unrestricted license such as either a LCSW, LMSW, LMHC, LPC, LMFT or Clinical ...
New
BH Care Manager II - Utilization Management
$79K - $119K/yr
Refers cases to Peer Reviewers as appropriate. * Performs psychiatric and substance abuse or ... Current, active, unrestricted license such as either a LCSW, LMSW, LMHC, LPC, LMFT or Clinical ...
New
BH Care Manager II - Utilization Management
Cerritos, CA · On-site
$79K - $119K/yr
Refers cases to Peer Reviewers as appropriate. * Performs psychiatric and substance abuse or ... Current, active, unrestricted license such as either a LCSW, LMSW, LMHC, LPC, LMFT or Clinical ...
New
BH Care Manager II - Utilization Management
Cerritos, CA · On-site
$79K - $119K/yr
Refers cases to Peer Reviewers as appropriate. * Performs psychiatric and substance abuse or ... Current, active, unrestricted license such as either a LCSW, LMSW, LMHC, LPC, LMFT or Clinical ...
New
BH Care Manager II - Utilization Management
Cerritos, CA · On-site
$79K - $119K/yr
Refers cases to Peer Reviewers as appropriate. * Performs psychiatric and substance abuse or ... Current, active, unrestricted license such as either a LCSW, LMSW, LMHC, LPC, LMFT or Clinical ...
BH Care Manager II - Utilization Management
Cerritos, CA · On-site
$79K - $119K/yr
Refers cases to Peer Reviewers as appropriate. * Performs psychiatric and substance abuse or ... Current, active, unrestricted license such as either a LCSW, LMSW, LMHC, LPC, LMFT or Clinical ...
BH Care Manager II - Utilization Management
Los Angeles, CA · On-site
$79K - $119K/yr
Refers cases to Peer Reviewers as appropriate. * Performs psychiatric and substance abuse or ... Current, active, unrestricted license such as either a LCSW, LMSW, LMHC, LPC, LMFT or Clinical ...
New
BH Care Manager II - Utilization Management
Los Angeles, CA · On-site
$79K - $119K/yr
Refers cases to Peer Reviewers as appropriate. * Performs psychiatric and substance abuse or ... Current, active, unrestricted license such as either a LCSW, LMSW, LMHC, LPC, LMFT or Clinical ...
New
Discharge Planner
Orange, CA · On-site
Maintain consistent contact with the utilization review team to monitor current and anticipated ... State of California License Preferred (LCSW, LPC or LMFT) * Minimum of one (1) experience in a ...
Discharge Planner
Orange, CA · On-site
Maintain consistent contact with the utilization review team to monitor current and anticipated ... State of California License Preferred (LCSW, LPC or LMFT) * Minimum of one (1) experience in a ...
Utilization Review Lpc information
What is the difference between Utilization Review Lpc vs Mental Health Counselor?
| Aspect | Utilization Review Lpc | Mental Health Counselor |
|---|---|---|
| Credentials | Licensed Professional Counselor (LPC) | Licensed Professional Counselor (LPC) or similar |
| Work Environment | Insurance companies, healthcare organizations, utilization review settings | Private practice, clinics, hospitals, community agencies |
| Primary Focus | Reviewing medical necessity, authorizing services, ensuring compliance | Providing therapy, mental health assessment, treatment planning |
The Utilization Review LPC primarily focuses on evaluating healthcare services for insurance approval and compliance, often working within healthcare organizations. In contrast, a Mental Health Counselor provides direct patient care through therapy and assessments. While both roles require LPC licensure, their work environments and responsibilities differ significantly.
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What job categories do people searching Utilization Review Lpc jobs in California look for? The top searched job categories for Utilization Review Lpc jobs in California are:
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Acadia Healthcare rating
6.2
Based on 190 frontline employees who took The Breakroom Quiz
700th of 887 rated healthcare providers
Job description
Salary Range:LMFT/LPCC/LCSW $33.00 - $50.00 per hour - Based on Experience
Salary Range: LVN $33.00 - $43.75 per hour - Based on Experience
Salary Range: RN: $60.00 - per hour - Based on Experience
Location: ONSITE ONLY
San Jose Behavioral Health is currently seeking a Utilization Review Specialist - Full Time to assist the Utilization Department staff with comprehensive inpatient care and treatment within our 133-bed Acute Psychiatric Hospital. San Jose Behavioral Health is where adults and adolescents can receive comprehensive inpatient treatment for a range of behavioral and mental health disorders. Conveniently located in the heart of San Jose the hospital is easily accessible to residents in Santa Clara County, San Mateo County, and Alameda County.
PURPOSE STATEMENT:
The Utilization Review Specialist coordinates and assesses the inpatient census for appropriate alternate health care service needs. Responsibilities include performing on-site and/or telephonic concurrent review of acute and sub-acute services, as well as pre-certification review for all services following the plans authorization guidelines. Also, coordinate with appropriate discharge planning processes, providing feedback on documentation processes; and functions as a resource to the clinical team regarding approved criteria, practice guidelines and alternative treatment options.
ESSENTIAL FUNCTIONS:
- Act as liaison between managed care organizations and the facility professional clinical staff.
- Conduct reviews, in accordance with certification requirements, of insurance plans or other managed care organizations (MCOs) and coordinate the flow of communication concerning reimbursement requirements.
- Monitor patient length of stay and extensions and inform clinical and medical staff on issues that may impact length of stay.
- Gather and develop statistical and narrative information to report on utilization, non-certified days (including identified causes and appeal information), discharges and quality of services, as required by the facility leadership or corporate office.
- Conduct quality reviews for medical necessity and services provided.
- Facilitate peer review calls between facility and external organizations.
- Initiate and complete the formal appeal process for denied admissions or continued stay.
- Assist the admissions department with pre-certifications of care.
- Provide ongoing support and training for staff on documentation or charting requirements, continued stay criteria and medical necessity updates.
OTHER FUNCTIONS:
- Perform other functions and tasks as assigned.
EDUCATION/EXPERIENCE/SKILL REQUIREMENTS:
- Associate Degree in Nursing(LPN/LVN/RN) Required.
- Bachelors or Masters degree in Social Work, Behavioral Health Or Mental Health, Nursing or Other related health field preferred.
- Two or more year's experience with the population of the facility preferred.
- Previous experience in utilization management is preferred
LICENSES/DESIGNATIONS/CERTIFICATIONS:
- LMFT, LMSW, LCSW, LPC, LPC-I within the state where the facility provides services; or current clinical professional license or certification, as required, within the state where the facility provides services.
- CPR and de-escalation and restraint certification required (training available upon hire and offered by facility.
ADDITIONAL REGULATORY REQUIREMENTS:
While this job description is intended to be an accurate reflection of the requirements of the job, management reserves the right to add or remove duties from particular jobs when circumstances
(e.g. emergencies, changes in workload, rush jobs or technological developments) dictate.
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About Acadia Healthcare
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Acadia Healthcare is a leading provider in the healthcare and hospital industry, based in Franklin, Tennessee, United States. The company is recognised for its commitment to creating a behavioural health network that provides accessible, high-quality treatment options for individuals suffering from mental health issues, addiction, eating disorders, and PTSD. Acadia Healthcare was founded in 2005, with the mission to create a world-class organization that sets the standard of excellence in the treatment of specialty behavioural health and addiction disorders.
Industry
Hospitals
Company size
10,000+ Employees
Headquarters location
Franklin, TN, US
Year founded
2005