Utilization Review Specialist

🔥 0 minutes ago

⛷️ Utah – Remote

⛷️ Utah – Remote

⏰ Full Time

🟡 Mid-level

🟠 Senior

👻 Ghost score 12%

What it means: how likely this posting is sitting open without active hiring.How to read it: 60% or higher means we think this is a ghost. Lower scores are less of a worry.How we score it: age, reposts, open roles vs team size, how fast jobs close, and whether pay is listed.Fine print: an estimate from public data, not a judgment of the company. Real jobs can score high, so treat it as a hint, not a fact.

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Odyssey House of Utah

WebsiteLinkedInAll Job Openings

201 - 500 employees

🏥 Healthcare

🤝 Non-profit

Healthcare • Non-profit

Odyssey House of Utah is a non-profit organization founded in 1971, dedicated to empowering people to heal and build better lives. As the largest and most comprehensive addiction program in Utah, Odyssey House provides mental health services, integrated medical care, and drug and alcohol rehabilitation programs. Their approach is mission-driven and focuses on treating the 'whole person' with evidence-based models, addressing all aspects of individual well-being to facilitate successful recovery and transformation.

📋 Description

• Track UCE/UR/Insurance due dates for all funding and ensure timely submission of requests • Review utilization review submissions for medical necessity, make corrections, and submit for approval • Provide ongoing training to staff regarding writing to medical necessity and other utilization-management issues • Resolve funding denials through immediate UR modification and resubmission to minimize loss of days • Update Best Notes and UWITS to reflect authorized days • Generate reports with due dates, notify staff of changes, and manage staff progress • Complete monthly Medicaid checks and upload snapshots to Best Notes • Complete “doc-to-doc” calls as needed for insurance authorization • Communicate with the OH billing department to resolve issues • Demonstrate fluency in ASAM and DSM-V through successful authorization and processing of utilization reviews • Complete all responsibilities in a timely, thorough, and professional manner • Perform other duties as assigned

🎯 Requirements

• Licensed Mental Health Professional, including - CSW, LCSW, CMHC, ACHMC, LMFT, MFTI • Graduate degree in the mental health field • Willingness and ability to pass a criminal background check • First Aid and CPR Certification (available at Odyssey House) • Must comply with annual TB tests and Flu immunization (and other immunizations as needed) • Must meet employment eligibility • Must be able to work variable shifts as needed • Ability to lift up to 15 lbs., drive (or adequate alternate transportation), sit for prolonged periods, and perform light to moderate physical activity at times • Able to passively restrain residents without likely injury to self due to existing medical condition • Adherence to Odyssey House mission, philosophy, scope of service, Division of Human Services Code of Conduct, and relevant service contract requirements • Understanding of role responsibilities, time management, personnel file requirements, client record system, incident reporting, mandatory training, client boundaries, and individual rights

🏖️ Benefits

• $9k per year tuition eligible • Access to 24/7 EAP program (Employee Assistance Program) for Mental Health support and more! • Opportunities for paid continuing education/training • Monthly incentives and awards • Flexible scheduling • Casual dress and atmosphere • Opportunities for bonuses, awards, raises, and promotions • Incredible health insurance (medical, dental, vision, FSA, long and short-term disability) • Immediate eligibility to participate in our 403(b)-retirement plan, Employer 100% match up to 5% after 1 year • 35 paid days off (additional PTO accrual after 1 year) • EXTRA time off and gift packages for PT and FT staff that stay more than 90 days! • Sabbatical Program - where we pay you to take a vacation after 5 years of service! • On-Demand Pay - Get a portion of your paycheck early for hours already worked! (conditions apply) • UTA free passes available for your work commute