Specialist, Utilization Review

Specialist, Utilization Review

Day Shift

Your experience matters

Centra Behavioral Health Hospital is part of Lifepoint Health, a diversified healthcare delivery network with facilities coast to coast. We are driven by a profound commitment to prioritize your well-being so you can provide exceptional care to others. By joining our team, you’re embracing a vital mission dedicated to making communities healthier ®. Join us on this meaningful journey where your skills, compassion and dedication will make a remarkable difference in the lives of those we serve.

More about our team

Centra Behavioral Health Hospital is a brand-new 72 bed behavioral health facility. We offer high-quality, compassionate care for a wide variety of patients in need. Our teams provide evidence-based, transformational care for a broad range of mental health concerns in a compassionate, comfortable environment.

 How you'll contribute 

A Specialist, Utilization Review who excels in this role:

• Demonstrates working knowledge of clinical criteria and managed care authorization requirements for inpatient and outpatient levels of care.
• Advocates on behalf of patients to obtain coverage for medically necessary services. 
• Completes initial and concurrent authorizations, including pre‑certifications and re‑certifications, for inpatient and outpatient services.
• Accurately communicates approval, denial, and authorization details to designated stakeholders.

• Reviews and analyzes patient clinical documentation to support medical necessity, appropriate treatment, and length of stay determinations.

   

Why join us 

We believe that investing in our employees is the first step to providing excellent patient care. In addition to your base compensation, this position also offers: 

• Comprehensive Benefits: Multiple levels of medical, dental and vision coverage for full-time and part-time employees.
• Financial Protection & PTO: Life, accident, critical illness, hospital indemnity insurance, short- and long-term disability, paid family leave and paid time off.
• Financial & Career Growth: Higher education and certification tuition assistance, loan assistance and 401(k) retirement package and company match.
• Employee Well-being: Mental, physical, and financial wellness programs (free gym memberships, virtual care appointments, mental health services and discount programs).
• Professional Development: Ongoing learning and career advancement opportunities.
• Brand new facility: Brand new hospital, built from the ground up, with cutting edge equipment and technology!

 What we're looking for

Applicants should have a bachelor’s degree in business administration, counseling, social work, nursing, or a related behavioral health field from an accredited school. Additional requirements include:

• Clinical, Social Work, or Nursing license preferred. 

• One year of utilization review/management experience in behavioral health preferred.  

• De-escalation certification is required within 30 days of employment and prior to any patient contact.

About Us 

Centra Behavioral Health Hospital is a 72-bed behavioral health hospital committed to offering exceptional care to the Lynchburg community. We are part of Lifepoint Health, a diversified healthcare delivery network committed to making communities healthier® with acute care, rehabilitation, and behavioral health facilities from coast to coast. 

Hourly range: $23.98-$32.37 per hour. 

EEOC Statement

Centra Behavioral Health Hospital is an Equal Opportunity Employer. Centra Behavioral Health Hospital is committed to Equal Employment Opportunity for all applicants and employees and complies with all applicable laws prohibiting discrimination and harassment in employment.