The Utilization Review Specialist is responsible for the authorizations and certifications process ... License : LPN, RN, LSW, LPC, LCDC or applicable license preferred Skills * Ability to multi-task
The Utilization Review Specialist is responsible for the authorizations and certifications process ... License : LPN, RN, LSW, LPC, LCDC or applicable license preferred Skills * Ability to multi-task
Utilization Review Director Shift: M-F Hours: 8-4:30 9-5 The Role Itself * Oversees service ... Must be 21 yrs or older License: * LPN, RN, LMSW, LPC, BSW, LSW, LPCC, LISW or applicable license ...
Utilization Review Director Shift: M-F Hours: 8-4:30 9-5 The Role Itself * Oversees service ... Must be 21 yrs or older License: * LPN, RN, LMSW, LPC, BSW, LSW, LPCC, LISW or applicable license ...
... Utilization Management (UM) Coordinator to join our team! Position Summary : The UM Coordinator ... with external review organizations or comparable entities. * License: LPN, RN, LMSW, LPC or ...
... Utilization Management (UM) Coordinator to join our team! Position Summary : The UM Coordinator ... with external review organizations or comparable entities. * License: LPN, RN, LMSW, LPC or ...
Intake Social Worker
Cleveland, OH · On-site
... utilization review preferred. * Education: Social Work, Mental Health/Behavioral Sciences required. Bachelor's or Master's Degree in related field preferred. * Licensure: LSW, LPC, MFT, LISW, LPCC or ...
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Intake Social Worker
Cleveland, OH · On-site
... utilization review preferred. * Education: Social Work, Mental Health/Behavioral Sciences required. Bachelor's or Master's Degree in related field preferred. * Licensure: LSW, LPC, MFT, LISW, LPCC or ...
Intake Social Worker
University Heights, OH · On-site
$60K/yr
... utilization review preferred. * Education:Social Work, Mental Health/Behavioral Sciences required. Bachelor's or Master's Degree in related field preferred. * Licensure:LSW, LPC, MFT, LISW, LPCC or ...
Intake Social Worker
University Heights, OH · On-site
$60K/yr
... utilization review preferred. * Education:Social Work, Mental Health/Behavioral Sciences required. Bachelor's or Master's Degree in related field preferred. * Licensure:LSW, LPC, MFT, LISW, LPCC or ...
Outpatient Navigator
Columbus, OH · On-site
$18.25 - $25/hr
... , LCSW, LPC, LMHC, LMFT) * Peer support specialist certification * Experience with PHP and IOP levels of care, discharge planning, and/or utilization review We are committed to providing equal ...
Outpatient Navigator
Columbus, OH · On-site
$18.25 - $25/hr
... , LCSW, LPC, LMHC, LMFT) * Peer support specialist certification * Experience with PHP and IOP levels of care, discharge planning, and/or utilization review We are committed to providing equal ...
Outpatient Navigator
$18.25 - $25/hr
... , LCSW, LPC, LMHC, LMFT) * Peer support specialist certification * Experience with PHP and IOP levels of care, discharge planning, and/or utilization review We are committed to providing equal ...
Outpatient Navigator
$18.25 - $25/hr
... , LCSW, LPC, LMHC, LMFT) * Peer support specialist certification * Experience with PHP and IOP levels of care, discharge planning, and/or utilization review We are committed to providing equal ...
Outpatient Navigator
Columbus, OH · On-site
$18.25 - $25/hr
... , LCSW, LPC, LMHC, LMFT) * Peer support specialist certification * Experience with PHP and IOP levels of care, discharge planning, and/or utilization review We are committed to providing equal ...
Outpatient Navigator
Columbus, OH · On-site
$18.25 - $25/hr
... , LCSW, LPC, LMHC, LMFT) * Peer support specialist certification * Experience with PHP and IOP levels of care, discharge planning, and/or utilization review We are committed to providing equal ...
Licensed Counselor or Social Worker
Middleport, OH · On-site
$47K - $71K/yr
Carries out utilization review and quality assurance activities as directed. * Maintains necessary ... Therapist Board. (LPC, LPCC, LSW, LISW) * Demonstrated high degree of cultural awareness.
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Licensed Counselor or Social Worker
Middleport, OH · On-site
$47K - $71K/yr
Carries out utilization review and quality assurance activities as directed. * Maintains necessary ... Therapist Board. (LPC, LPCC, LSW, LISW) * Demonstrated high degree of cultural awareness.
Licensed Counselor or Social Worker
$61K - $71K/yr
Vinton County, OH LSW, LPC, LISW, LPCC Join our team! Integrated Services for Behavioral Health ... Carries out utilization review and quality assurance activities as directed. * Maintains necessary ...
Licensed Counselor or Social Worker
$61K - $71K/yr
Vinton County, OH LSW, LPC, LISW, LPCC Join our team! Integrated Services for Behavioral Health ... Carries out utilization review and quality assurance activities as directed. * Maintains necessary ...
Licensed Counselor or Social Worker
New Lexington, OH · On-site
$47K - $71K/yr
Carries out utilization review and quality assurance activities as directed. * Maintains necessary ... LPC, LSW) * Demonstrated high degree of cultural awareness. * Experience with multi-need ...
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Licensed Counselor or Social Worker
New Lexington, OH · On-site
$47K - $71K/yr
Carries out utilization review and quality assurance activities as directed. * Maintains necessary ... LPC, LSW) * Demonstrated high degree of cultural awareness. * Experience with multi-need ...
Licensed Counselor or Social Worker
Mcarthur, OH · On-site
$61K - $71K/yr
Vinton County, OH LSW, LPC, LISW, LPCC Join our team! Integrated Services for Behavioral Health ... Carries out utilization review and quality assurance activities as directed. * Maintains necessary ...
Licensed Counselor or Social Worker
Mcarthur, OH · On-site
$61K - $71K/yr
Vinton County, OH LSW, LPC, LISW, LPCC Join our team! Integrated Services for Behavioral Health ... Carries out utilization review and quality assurance activities as directed. * Maintains necessary ...
Interacts on a regular and consistent basis with physicians, nursing staff, and utilization review ... If LSW or LPC, Bachelor's degree in Social Work. 2. Ability to perform data analysis and to utilize ...
Interacts on a regular and consistent basis with physicians, nursing staff, and utilization review ... If LSW or LPC, Bachelor's degree in Social Work. 2. Ability to perform data analysis and to utilize ...
Interacts on a regular and consistent basis with physicians, nursing staff, and utilization review ... If LSW or LPC, Bachelor's degree in Social Work. 2. Ability to perform data analysis and to utilize ...
Interacts on a regular and consistent basis with physicians, nursing staff, and utilization review ... If LSW or LPC, Bachelor's degree in Social Work. 2. Ability to perform data analysis and to utilize ...
Interacts on a regular and consistent basis with physicians, nursing staff, and utilization review ... If LSW or LPC, Bachelor's degree in Social Work. 2. Ability to perform data analysis and to utilize ...
Interacts on a regular and consistent basis with physicians, nursing staff, and utilization review ... If LSW or LPC, Bachelor's degree in Social Work. 2. Ability to perform data analysis and to utilize ...
Communicates with utilization review * Completes thorough, timely documentation in compliance with standards. * Demonstrates crisis intervention skills and upholds confidentiality. * Possesses a ...
Communicates with utilization review * Completes thorough, timely documentation in compliance with standards. * Demonstrates crisis intervention skills and upholds confidentiality. * Possesses a ...
Primary Therapist
Hilliard, OH · On-site
$58K - $76K/yr
Actively communicates with the Clinical Director and Utilization Review in regards to the status ... LPC, Licensed Clinical Social Worker-LCSW, Licensed Marriage and Family Therapist-LMFT) * BLS ...
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Primary Therapist
Hilliard, OH · On-site
$58K - $76K/yr
Actively communicates with the Clinical Director and Utilization Review in regards to the status ... LPC, Licensed Clinical Social Worker-LCSW, Licensed Marriage and Family Therapist-LMFT) * BLS ...
Licensed Counselor or Social Worker
Cambridge, OH · On-site
$61K - $71K/yr
Noble County, OH LSW, LPC, LISW, LPCC Join our team! Integrated Services for Behavioral Health ... Carries out utilization review and quality assurance activities as directed. * Maintains necessary ...
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Licensed Counselor or Social Worker
Cambridge, OH · On-site
$61K - $71K/yr
Noble County, OH LSW, LPC, LISW, LPCC Join our team! Integrated Services for Behavioral Health ... Carries out utilization review and quality assurance activities as directed. * Maintains necessary ...
Licensed Counselor or Social Worker
Piketon, OH · On-site
$61K - $71K/yr
Pike County, OH LSW, LPC, LISW, LPCC This position is eligible for a sign-on bonus of $3,000!! Join ... Carries out utilization review and quality assurance activities as directed. * Maintains necessary ...
Licensed Counselor or Social Worker
Piketon, OH · On-site
$61K - $71K/yr
Pike County, OH LSW, LPC, LISW, LPCC This position is eligible for a sign-on bonus of $3,000!! Join ... Carries out utilization review and quality assurance activities as directed. * Maintains necessary ...
Clinical Social Worker
Cleveland, OH · On-site
Collaborate with Utilization Review Coordinator and other members of the healthcare team to provide ... Valid Ohio social work or counseling license (LSW, LPC, MFT). * Master's Degree in Social Work ...
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Clinical Social Worker
Cleveland, OH · On-site
Collaborate with Utilization Review Coordinator and other members of the healthcare team to provide ... Valid Ohio social work or counseling license (LSW, LPC, MFT). * Master's Degree in Social Work ...
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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Full-time
Medical, Dental, Vision, Life, Retirement, PTO
Re-posted 27 days ago
Job description
Job Address:
10123 Alliance Road, Suite 320 Blue Ash, OH 45242UR Specialist.
Shift: M-Fr 8-5
This is not a remote position. It is an office-based position in Cincinnati, Ohio.
Who we are
At NewVista, the mission is to inspire hope and deliver holistic care to those in need of behavioral health services and addiction services in a safe and healing environment.We operate Behavioral Health Hospitals, Detox and Residential facilities, and a variety of other vertical line business that are here to support those who are seeking recovery.
The Role Itself
Position Summary:The Utilization Review Specialist is responsible for the authorizations and certifications process for Inpatient and Outpatient Services. This includes the precertification and recertification process, peer to peer reviews, and appeal. The UR Specialist will accurately report the authorization status of patients, denials and appeals status to the Corporate Director of UR.The UR Specialist will follow department and department procedures and ensure effective communication with all relevant departments regarding patient care needs.
JOB RESPONSIBILITIES
As Utilization Review Specialist, you will :
- Obtain Continued Stay Reviews for Inpatient and Outpatient behavioral health treatment.
- Follow up on prior authorization submissions that need further information to obtain authorization.
- Display 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.
- Strong working knowledge of external review organizations (ie: Medicare/Managed Care/Medicaid) with knowledge of payor resources and planning.
- Report appropriate denial and authorization information to designated resource.
- Coordinate authorization information with third party payors in a timely manner.
- Complete thorough and accurate documentation in all required systems.
- Maintain communication system based on documentation and verbal exchange regarding treatment with other UM staff and staff at the facilities as needed.
- Schedule and follow up on results of Peer to Peer requests for physicians and CNP.
- Maintain Denial Log
Education
- High school diploma or GED (Required), Bachelor's Degree or Master's Degree in Nursing, Social Work, Mental Health/Behavioral Sciences, or related field preferred.
- Previous Utilization Review experience in a behavioral healthcare facility preferred.
- License: LPN, RN, LSW, LPC, LCDC or applicable license preferred
Skills
- Ability to multi-task
- Strong organization skills
- Strong problem-solving skills
- Ability to work well independently and as part of a team
Perks at Work
Healthcare:
- Medical Packages with Rx - 3 Choices
- Flexible Spending Accounts (FSA)
- Dependent Day Care Spending Accounts
- Health Spending Accounts (HSA) with a company match
- Dental Care Program - 2 choices
- Vision Plan
- Life Insurance Options
- Accidental Insurances
- Paid Time Off + Paid Holidays
- Employee Assistance Programs
- 401k with a Company Match
Education + Leadership Development
- Up to $15,000 in Tuition Reimbursements
- Student Loan Forgiveness Programs
Our overall mission is to Inspire Hope, Restore Peace of Mind and Heal Lives.