Utilization Review Specialist - Nashville, United States - Charlie Health

Description

Job Description

Job Description

Why Charlie Health?

Young people across the nation are grappling with a mental health crisis characterized by escalating rates of depression, anxiety, trauma, substance use disorders, and suicide.

Individuals who seek support are met by geographical and financial barriers, driving increased urgency for a new approach to behavioral health treatment.

At Charlie Health, our mission is to connect the world to life-saving mental health treatment.

Our treatment programs combine curated peer groups, individual therapy, and family therapy into personalized, evidence-based treatment plans to provide long-term healing from home.

By prioritizing connections among young people with shared mental health experiences and goals, Charlie Health fosters sustainable healing and achieves industry-leading clinical outcomes, with over 90% of our clients seeing improvement in their most severe mental health symptoms.

Every member of the Charlie Health team is fueled by an unwavering passion for our mission.

If you share this commitment, we invite you to join us in making a tangible impact on the mental health landscape.

About the Role

The purpose of this position is to ensure that the utilization process is thorough, organized and streamlined to provide the best possible length of stays for our patients.

Given the complex nature of insurance these days, it is crucial to have timely communication with these payors so that families can focus on what's important, getting their loved ones the care they need.

Our team is comprised of passionate, forward-thinking professionals eager to take on the challenge of the mental health crisis and play a formative role in providing life-saving solutions.

We are looking for a candidate who is inspired by our mission and excited by the opportunity to build a business that will impact millions of lives in a profound way.

Responsibilities

Oversees all functions of a virtual IOP caseload
Completes peer reviews on cases with insurance
Collaborates at a high level to problem solve on complex cases with Manager
Completes pre-certs and continued stay authorizations for virtual IOP clients in a timely manner
Follows up on all outstanding authorizations and reports all barriers to Manager
Collaborates with Revenue Team and Admissions to improve patient experience from the front door through discharge
Partners with Manager and Director to troubleshoot workflows and processes to achieve efficiency gains in current and future company systems
Delivers frequent training to clinical teams for high quality documentation standardization
Consulting across teams, providing mentorship, and contributing specialized knowledge
Requirements

Master's Degree in healthcare field preferred
2+ years of experience in a utilization role within the healthcare field required
Microsoft Office and Salesforce proficiency
Strong interpersonal, relationship-building and listening skills, with a natural, consultative style
Ability to energize, communicate, and build rapport at all levels within an organization
Strong project management skills, with a demonstrable ability to corral and manage details in a fast-paced, fluid environment
Experience advising, presenting to, and persuading senior corporate personnel
Knowledge of all confidentially requirements regarding patients and strict maintenance of proper confidentiality on all such information.
Excellent written and verbal communication skills
Organizational skills
Ability to maintain a high level of integrity and confidentiality of medical information
Strict attention to details
Benefits

Charlie Health is pleased to offer comprehensive benefits to all full-time, exempt employees. Read more about our benefits here.
Additional Information

Note:
We are not currently considering applicants in CA, CO, NY, and WA for this position. #LI-Remote
Our Values

Connection
Care deeply
We care personally about every single person in the Charlie Health ecosystem: our clients, providers, and team members alike.
Inspire hope
We inspire hope with every interaction, reminding our clients that we truly and unconditionally believe in them.
Congruence
Stay curious
We ask "why" five times before we're satisfied with the answer. We don't stick to the status quo; we challenge our assumptions and remain humble.
Heed the evidence
Above all, we're results-oriented. When we find data that calls our original plan into question, we modify or pivot.
Commitment
Act with urgency
We work as swiftly as possible. The mental health crisis is relentless, and so are we.
Don't give up
Our clients don't give up and neither do we. Persistence is our superpower.

Please do not call our public clinical admissions line in regard to this or any other job posting.
Please be cautious of potential recruitment fraud.

If you are interested in exploring opportunities at Charlie Health, please go directly to our Careers Page:

-openings. Charlie Health will never ask you to pay a fee or download software as part of the interview process with our company. In addition, Charlie Health will not ask for your personal banking information until you have signed an offer of employment and completed onboarding paperwork that is provided by our People Operations team. All communications with Charlie Health Talent and People Operations professionals will only be sent from email addresses. Legitimate emails will never originate from , , or other commercial email services.
Recruiting agencies, please do not submit unsolicited referrals for this or any open role.

We have a roster of agencies with whom we partner, and we will not pay any fee associated with unsolicited referrals.

At Charlie Health, we value being an Equal Opportunity Employer. We strive to cultivate an environment where individuals can be their authentic selves. Being an Equal Opportunity Employer means every member of our team feels as though they are supported and belong.

We value diverse perspectives to help us provide essential mental health and substance use disorder treatments to all young people.

Charlie Health applicants are assessed solely on their qualifications for the role, without regard to disability or need for accommodation.

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