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Utilization Review Specialist (Psychologist)

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Job Details

Job Overview:

  • The Utilization Review Specialist Psychologists will support our Utilization Review department by working closely with patients, insurance companies, and the entire treatment team.

Job Responsibilities:

  • Act as an advocate for patients to ensure their treatment needs are met.
  • Interact with insurance companies in a professional manner.
  • Complete precertification and concurrent reviews with insurance companies to obtain authorization for treatment.
  • Act as a resource to the medical and clinical staff for all issues relating to utilization management.
  • Support therapeutic team members and participate in team activities.
  • Perform other duties and projects as assigned.

Qualifications:

  • Masters in Mental Health or Psychiatric Nursing.
  • Independent licensure in Mental Health or Psychiatric Nursing preferred.
  • Must have at least 5 years of clinical experience.
  • Must possess strong clinical assessment skills.
  • Be a strong team player who works well in a collaborative-team environment.
  • Experience completing pre-certifications and concurrent reviews preferred.
  • Able to organize daily schedule and prioritize cases according to level of care and due dates.
About the Company
Tranquil & Quest Medical and Diagnostics Limited

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