Utilization Review SpecialistMindful Health • Saint Paul, Illinois, United States
Utilization Review Specialist
Mindful Health
- Saint Paul, Illinois, United States
- Saint Paul, Illinois, United States
À propos
Job Summary Utilization Review Specialist: responsible for ensuring adherence to Mindful Health’s utilization review plan by evaluating the efficiency, effectiveness, and medical necessity of outpatient services, including admissions and extended treatment.
*Must reside in Texas*
Duties/Responsibilities
Establish processes to verify the medical necessity and appropriateness of outpatient admissions
Conduct concurrent reviews to ensure extended stays are justified and properly documented
Track patient lengths of stay and continued‑stay days
Refer non‑compliant cases to the Physician Advisor for further evaluation
Collaborate with the Utilization Review Committee to identify and resolve review‑related issues
Flag quality‑of‑care concerns and escalates them to the Quality Assurance Committee
Coordinate with Social Services to support timely discharge planning
Prepare and present monthly utilization reports and key metrics
Required Skills
Strong verbal and written communication abilities
Exceptional organizational skills and keen attention to detail
Proven time‑management skills with the ability to meet deadlines consistently
Proficiency in Microsoft Office Suite and related software applications
Education and Experience
Associate's or Bachelor’s degree in a healthcare related field preferred
1–2 years of experience in utilization review
Active CPR certification
Physical Requirements
Ability to sit at a desk and work on a computer for extended periods
Capable of lifting, holding, pushing, and pulling up to 15 pounds
Proficient in typing, navigating, and viewing monitors for prolonged durations
Visual acuity to view monitors with close vision, color perception, depth perception, and focus adjustment
Effective verbal and written communication skills to engage with patients, team members, and customers
Ability to read, write, and comprehend information through active listening
Consistent performance of essential job functions in accordance with ADA, FMLA, and applicable federal, state, and local regulations, including meeting productivity standards
Reliable and punctual attendance aligned with workplace standards
Flexibility to work at multiple locations during a scheduled work week
Mobility to move throughout the office or client sites to assist patients as needed
Mindful Health offers
A healthy & positive atmosphere where everyone is valued
Schedule: Monday‑Friday, 8AM‑5PM CST
120 hours (15 days) of paid time off annually
9 paid holidays
40 hours (5 days) of sick leave
24 hours (3 days) of bereavement leave per occurrence
Comprehensive medical and supplemental health insurance, including vision, dental, life insurance, & both short‑ and long‑term disability
Opportunities for professional development and continued education
The job description is not designed to cover or contain a comprehensive listing of activities, duties or responsibilities that are required of the employee. Duties, responsibilities, and activities may change, or new ones may be assigned at any time with or without notice. Employee signature below indicates the employee’s understanding of the requirements, essential functions, and duties of the position.
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Compétences linguistiques
- English
Avis aux utilisateurs
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