Top 15 Behavioral health utilization management specialist Jobs in Columbus

Utilization Review Specialist - Autism
Nationwide Children's Hospital —Columbus, OH
- Full-time
- Customer service
- Writing skills
- Mid-level
- Work from home
Utilization Management Specialist
ST VINCENT FAMILY SERVICES —Columbus, OH
- Weekends as needed
- Hybrid work
- Microsoft Excel
- Microsoft Outlook
- HIPAA
- Paid time off
- 401(k) matching
Quick Apply
Client Insurance Specialist
Integrated Services for Behavioral Health —Columbus, OH
- $20.97 - $24.56 an hour
- Hybrid work
- Mid-level
- Organizational skills
- 2 years
- Disability insurance
- Health insurance
Quick Apply
Clinical Services Specialist
Delaware County, OH —Delaware, OH
- $29.22 - $47.13 an hour
- Overtime
- Psychiatry
- Addiction Medicine
- 5 years
Shift Supervisor
Recovery Innovations —Columbus, OH
- $39 - $41 an hour
- Full-time
- Background check
- LMFT
- 18 years or older
- Health insurance
- Dental insurance
Quick Apply
Revenue Cycle Manager
ST VINCENT FAMILY SERVICES —Columbus, OH
- Full-time
- Microsoft Excel
- Microsoft Access
- Writing skills
Quick Apply
Hospital Senior Account Manager, Anti-Infectives - Columbus, OH / WV
GlaxoSmithKline —Columbus, OH
- $165,000 - $275,000 a year
- Full-time
- Remote
- Up to 50% travel
- Hospital
- Bachelor of Science
- Paid holidays
- Health insurance
9h
Clinician (Counselor) - Franklinton
Basecamp Recovery Center —Columbus, OH
- $26 - $38 an hour
- Weekends as needed
- LMFT
- Spanish
- CPR Certification
- Paid holidays
- Loan repayment program
Quick Apply
Clinician - Franklinton
BASECAMP RECOVERY LLC —Columbus, OH
- $24 an hour
- Weekends as needed
- LMFT
- Spanish
- CPR Certification
- Paid holidays
- Health insurance
Quick Apply
14d
Licensed Adult Behavioral Therapist – LISW / LPCC
AbsoluteCare —Columbus, OH
- CPR Certification
- Microsoft Outlook
- BLS Certification
Quick Apply
5d
Athletic Trainer - Orthopedic Surgery
OhioHealth —Columbus, OH
- Full-time
- 18 years or older
- CPR Certification
- Surgery
- Opportunities for advancement

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Utilization Review Specialist - Autism
Nationwide Children's Hospital —Columbus, OH
Bachelor’s Degree in Social Work, Psychology, or related field, required. Conducts utilization reviews of behavioral health cases to determine medical necessity…
Utilization Management Specialist
ST VINCENT FAMILY SERVICES —Columbus, OH
Associate's Degree required; Bachelor's Degree preferred in Healthcare Administration, Business Administration, Social Work, Public Health, or related field.
Quick Apply

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behavioral health utilization management specialist jobs near columbus

Utilization Review Specialist - Autism

Nationwide Children's Hospital -
Columbus, OH

Apply Now

Job Details

Full-time

Benefits

Work from home

Qualifications

Bachelor's degree
Pediatrics
Working with individuals with mental health conditions

Full Job Description

Overview:

Schedule: Monday-Friday (8:00am-4:30pm)

Position is work from home after a 90 day in-office training period.

Job Description Summary:

Reviews behavioral health cases to determine medical necessity and appropriateness of care, ensuring compliance with established guidelines and policies. Performs pre-certifications, pre-authorizations, re-authorization, concurrent utilization reviews, retrospective reviews, and denial management. Interacts with staff and departments of the hospital to facilitate appropriate, cost-effective patient care.

Job Description:

Essential Functions:

Conducts utilization reviews of behavioral health cases to determine medical necessity, appropriateness of care, and adherence to clinical guidelines.
Communicates with healthcare teams and third-party payors to ensure the delivery of quality care and optimum payment.
Assists with retrospective reviews and denial management to maintain appropriate and cost-effective patient care.
Documents all case reviews and maintains accurate records of all clinical activities and coverage information.
Provides education and support regarding utilization review and management activities and processes.
Analyzes clinical data to identify trends and patterns that may impact patient care. Participates in quality improvement initiatives to enhance the overall delivery of behavioral health services.
Facilitates reimbursement by communicating with payers, other staff, patients, and families concerning status of funding and required actions.

Education Requirement:

Bachelor’s Degree in Social Work, Psychology, or related field, required.

Licensure Requirement:

(not specified)

Certifications:

(not specified)

Skills:

Excellent written and verbal communication and interpersonal skills.
Excellent customer service and organizational skills.
Working knowledge of CMS and other review agency standards.
Proficient with software applications including CM, payer web applications, MITS, and others.

Experience:

Three years of behavioral health experience, required.
One year of experience in pediatric care or services, required.
Utilization review or utilization management experience, preferred.

Physical Requirements:

OCCASIONALLY: Bend/twist, Climb stairs/ladder, Flexing/extending of neck, Lifting / Carrying: 0-10 lbs, Reaching above shoulder, Squat/kneel

FREQUENTLY: Standing, Walking

CONTINUOUSLY: Audible speech, Color vision, Computer skills, Decision Making, Depth perception, Hand use: grasping, gripping, turning, Hearing acuity, Interpreting Data, Peripheral vision, Problem solving, Repetitive hand/arm use, Seeing – Far/near, Sitting

Additional Physical Requirements performed but not listed above:

(not specified)

"The above list of duties is intended to describe the general nature and level of work performed by individuals assigned to this classification. It is not to be construed as an exhaustive list of duties performed by the individuals so classified, nor is it intended to limit or modify the right of any supervisor to assign, direct, and control the work of employees under their supervision. EOE M/F/Disability/Vet"

Apply Now

Refine Your Search

behavioral health utilization management specialist jobs in columbus

Utilization Review Specialist - Autism

Utilization Management Specialist

Client Insurance Specialist

Clinical Services Specialist

Shift Supervisor

Revenue Cycle Manager

Hospital Senior Account Manager, Anti-Infectives - Columbus, OH / WV

Clinician (Counselor) - Franklinton

Clinician - Franklinton

Licensed Adult Behavioral Therapist – LISW / LPCC

Athletic Trainer - Orthopedic Surgery

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