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Utilization Review Specialist
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- JOB TITLE: Utilization Review Specialist DEPARTMENT: Utilization Review REPORTS TO: Utilization Review Coordinator The Utilization Review Specialist supports Cumberland Heights' mission of transforming lives, providing hope and healing to persons and their families affected by the disease of addiction.
- POSITION SUMMARY The Utilization Review Specialist is responsible for communicating pertinent information between the organization's staff and various third party payors and managed care organizations in order to ensure maximum benefit from treatment services and the insurance benefits available.
- Communicates decisions and requests of third party payors and/or managed care organizations back to clinical staff, serving as liaison between the two.
- Monitors utilization of resources and lengths of stay for courtesy and scholarship patients.
- Works with and develops professional relationship and trust with provider/payor UR staffs.
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