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Utilization Review Specialist

Newport Healthcare
tuition reimbursement
United States, California, Irvine
19200 Von Karman Avenue (Show on map)
Feb 19, 2025
About Us

Transform Lives with Newport Healthcare!

Are you ready to make a meaningful impact in the world of behavioral healthcare? Newport Healthcare, a leading nationwide organization, is dedicated to transforming the lives of young people through evidence-based care, and we want YOU to join our mission!

We have assembled the finest mental health treatment professionals in the country, and as part of our team, you will play a vital role in guiding clients toward sustainable healing. At Newport Healthcare, we prioritize the well-being of our staff by offering industry-competitive salaries, opportunities for career growth and skills expansion, student loan repayment, tuition reimbursement, and a strong commitment to diversity, equity, and inclusion.

Join a compassionate team that values authentic connection, mutual respect, and unconditional love. Experience the profound rewards of making a difference in the lives of young individuals and their families every day.

Empowering Lives. Restoring Families.

If you're ready to embark on a fulfilling career where you can truly make an impact, apply now and be part of something extraordinary at Newport Healthcare!


Responsibilities

Are you passionate about making a difference in the lives of clients seeking behavioral health treatment? Newport Healthcare is looking for a dedicated Utilization Review Specialist to join our team! In this vital role, you will manage an active caseload of clients across various Levels of Care, including Detox, Residential, Partial Hospitalization, and Intensive Outpatient.

As a liaison between insurance companies, clients, their families, and our Clinical Team, you will play a crucial role in ensuring that each client receives the coverage and benefits they deserve. Your expertise in case-building and collaboration will help optimize client care and support their journey to recovery.

Key Responsibilities:
  • Timely Reviews: Coordinate, schedule, and complete initial, concurrent, peer, and retrospective reviews to ensure continuous coverage, utilizing your clinical knowledge and understanding of Medical Necessity criteria.
  • Professional Representation: Conduct and manage reviews while representing the Utilization Review Department positively to other departments and the organization as a whole.
  • Family Communication: Maintain regular contact with clients' families, keeping them informed about insurance authorization updates, peer reviews, and denials.
  • Detailed Documentation: Document all activities meticulously in the applicable CRM/EMR to ensure accurate records.
  • Collaborative Approach: Work closely with clinicians and the multidisciplinary team daily to obtain necessary clinical documentation and ensure effective resource utilization.
  • Team Participation: Engage in weekly Treatment Team and Continuing Care Meetings to contribute to comprehensive client care.
  • Appeal Preparation: Prepare and submit appeal documentation, including rationales, to the appropriate entities as needed.
  • Ongoing Updates: Complete weekly Treatment Team notes and provide updates to the Psychiatrist as requested by the Director/Manager.
  • Chain of Command: Follow the established chain of command within and outside the department for effective communication and operations.

If you are ready to take on this rewarding role and help clients navigate their treatment journey, we want to hear from you! Join Newport Healthcare and be part of a team that values compassion, collaboration, and excellence in behavioral health care.

Apply today and make a meaningful impact in the lives of those we serve!


Qualifications

What We're Looking For:
  • Experience: At least two (2) years of work experience in the behavioral health field.
  • Licensure: An active license or credential in a behavioral health field is preferred.
  • Education: A Bachelor's or Master's degree in a behavioral health-related specialty is preferred.
Position Details:
  • Schedule: This is a full-time position, working Monday to Friday from 6:30 AM to 3 PM PST / 8:30 AM to 5 PM CST / 9:30 AM to 6 PM EST.
  • Location: You must live within driving distance to a Newport location, with the requirement to report on-site once a week.

If you are ready to take on this impactful role and contribute to the well-being of individuals in need, we want to hear from you! Join Newport Healthcare and be part of a team that values compassion, collaboration, and excellence in behavioral health care.

Apply today and help us empower lives and restore families!

We are excited to hear about your interest in this opportunity! If you have any questions or need assistance with the application process, please feel free to contact me directly at Sydney Spencer, either via email at sydney.spencer@newporthealthcare.com or by phone at 615-961-4138. If you need further support, you are also welcome to reach out to our careers and management team at careers@newporthealthcare.com.

Newport Healthcare is an Equal Opportunity Employer.

Newport Healthcare provides equal employment opportunities to all employees and applicants for employment and prohibits discrimination and harassment of any type without regard to race, color, religion, age, sex, sexual orientation, gender identity, national origin, disability status, protected veteran status, genetic information, or any other characteristic protected by federal, state, or local laws.

Newport Healthcare is committed to ensuring equal employment opportunity, including providing reasonable accommodations to individuals with a disability. Applicants with a physical or mental disability who require a reasonable accommodation for any part of the application or hiring process please email accommodations@newportacademy.com for assistance.

For more information on Equal Opportunity, please click here Equal Employment Opportunity Posters

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