Utilization Specialist

Cooper Riis•Asheville, NC

7d•$22•Onsite

About The Position

The Utilization Specialist works closely with the CRA Integrative Recovery Team by providing support with family communication and acts as a liaison between the organization, insurance, and families/residents. They initiate the first communication with families regarding insurance changes, oversees coordination for every resident’s care and acts as a lead to the Care Coordinators in fulfilling their role. The Utilization Specialist also coordinates the CooperRiis Spravato treatment for residents.

Requirements

Experience working with adults recovering from significant mental health challenges and preferably in a residential mental health or substance use recovery setting
Working knowledge of insurance utilization and ability to collaborate with the finance department on supporting families and residents with their insurance questions and concerns

Nice To Haves

Preferred Master’s Degree in psychology, social work, or other related field

Responsibilities

Calls families within 24 hours of admission, alerts them of denials and/or insurance changes, and provides a bridge to the finance department if there are additional questions
Coordinates with Care Coordinator and therapist to alert residents of insurance status changes and supports communication with the fiancé department as needed
Coordinate the Spravato program, working with prescriber and nursing team to complete VOB, prior authorization, scheduling, and guiding residents through the session.
Completes all related documentation
Oversees the care coordination, and guiding the care coordinator team on discharge planning and implementation
Works closely with the team and residents promoting movement through the program and addressing logistical barriers to discharge planning
In collaboration with the Recovery Team, develops, maintains, and is knowledgeable on a library of resources for referral purposes
Attends weekly scheduled meetings