Utilization Specialist
Burns, TN · On-site
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
Burns, TN · On-site
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
Louisville, TN · On-site
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 ...
New
Utilization Specialist
Louisville, TN · On-site
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 ...
New
Utilization Specialist
Memphis, TN · On-site
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
Memphis, TN · On-site
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
Memphis, TN · On-site
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
Memphis, TN · On-site
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
Memphis, TN · On-site
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
Memphis, TN · On-site
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 ...
New
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 ...
New
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
Burns, TN · On-site
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
Burns, TN · On-site
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 ...
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 ...
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 ...
UR Coordinator - Full-time
Memphis, TN · On-site
Valid TN RN license, LCSW, or LPC preferred. Knowledge: Must possess knowledge of psychiatric care, utilization review, insurance reimbursement procedures, DSM-V, etc. Advanced computer skills ...
UR Coordinator - Full-time
Memphis, TN · On-site
Valid TN RN license, LCSW, or LPC preferred. Knowledge: Must possess knowledge of psychiatric care, utilization review, insurance reimbursement procedures, DSM-V, etc. Advanced computer skills ...
Valid TN RN license, LCSW, or LPC preferred. Knowledge: Must possess knowledge of psychiatric care, utilization review, insurance reimbursement procedures, DSM-V, etc. Advanced computer skills ...
Valid TN RN license, LCSW, or LPC preferred. Knowledge: Must possess knowledge of psychiatric care, utilization review, insurance reimbursement procedures, DSM-V, etc. Advanced computer skills ...
Valid TN RN license, LCSW, or LPC preferred. Knowledge: Must possess knowledge of psychiatric care, utilization review, insurance reimbursement procedures, DSM-V, etc. Advanced computer skills ...
Valid TN RN license, LCSW, or LPC preferred. Knowledge: Must possess knowledge of psychiatric care, utilization review, insurance reimbursement procedures, DSM-V, etc. Advanced computer skills ...
Clinical Case Manager Behavioral Health DSNP
Nashville, TN · Remote
$54.10K - $116.76K/yr
... LPC, LP, LMFT, LMHC) 3+ years of post‐master's direct clinical experience 3+ years of strong ... utilization review experience Discharge planning or care coordination experience Why You'll Love ...
Clinical Case Manager Behavioral Health DSNP
Nashville, TN · Remote
$54.10K - $116.76K/yr
... LPC, LP, LMFT, LMHC) 3+ years of post‐master's direct clinical experience 3+ years of strong ... utilization review experience Discharge planning or care coordination experience Why You'll Love ...
Intake Clinician - OP- LPC, LMFT, LCSW, Required
Knoxville, TN · On-site
$59.20K - $81.10K/yr
Experience in the managed care pre-certification process, level of care assessments and utilization ... review organizations or comparable entities, and working effectively with people of diverse ...
Intake Clinician - OP- LPC, LMFT, LCSW, Required
Knoxville, TN · On-site
$59.20K - $81.10K/yr
Experience in the managed care pre-certification process, level of care assessments and utilization ... review organizations or comparable entities, and working effectively with people of diverse ...
Review appeal outcomes and metrics, ensuring that the team meets established goals related to ... Strong understanding of utilization management principles and practices. Experience with CARF and ...
New
Review appeal outcomes and metrics, ensuring that the team meets established goals related to ... Strong understanding of utilization management principles and practices. Experience with CARF and ...
New
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.
What are popular job titles related to Utilization Review Lpc jobs in Tennessee? For Utilization Review Lpc jobs in Tennessee, the most frequently searched job titles are:
What job categories do people searching Utilization Review Lpc jobs in Tennessee look for? The top searched job categories for Utilization Review Lpc jobs in Tennessee are:
What cities in Tennessee are hiring for Utilization Review Lpc jobs? Cities in Tennessee with the most Utilization Review Lpc job openings:
Acadia Healthcare rating
6.1
Based on 183 frontline employees who took The Breakroom Quiz
708th of 864 rated healthcare providers
Job description
Overview
PURPOSE STATEMENT:
Proactively monitor utilization of services for patients to optimize reimbursement for the facility.
Responsibilities
ESSENTIAL FUNCTIONS:
OTHER FUNCTIONS:
Qualifications
EDUCATION/EXPERIENCE/SKILL REQUIREMENTS:
LICENSES/DESIGNATIONS/CERTIFICATIONS:
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.
We are committed to providing equal employment opportunities to all applicants for employment regardless of an individual's characteristics protected by applicable state, federal and local laws.
LI-MLRC
MIRLK
PURPOSE STATEMENT:
Proactively monitor utilization of services for patients to optimize reimbursement for the facility.
Responsibilities
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.
Qualifications
EDUCATION/EXPERIENCE/SKILL REQUIREMENTS:
- Required Education: High school diploma or equivalent.
- Preferred Education: Associate's, Bachelor's, or Master's degree in Social Work, Behavioral or Mental Health, Nursing, or a related health field.
- Experience: Clinical experience is required, or two or more years' experience working with the facility's population. Previous experience in utilization management is preferred
LICENSES/DESIGNATIONS/CERTIFICATIONS:
- Preferred Licensure: LPN, RN, 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.
- First aid may be required based on state or facility requirements.
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.
We are committed to providing equal employment opportunities to all applicants for employment regardless of an individual's characteristics protected by applicable state, federal and local laws.
LI-MLRC
MIRLK
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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