Utilization Review Specialist at KVC Health Systems

Wichita, Kansas, United States -

Full Time

Start Date

Immediate

Expiry Date

19 Aug, 26

Salary

18.0

Posted On

21 May, 26

Experience

2 year(s) or above

Remote Job

Yes

Telecommute

Yes

Sponsor Visa

Skills

Utilization Review, Case Management, Insurance Coordination, Clinical Documentation, Microsoft Word, Microsoft Excel, Microsoft Outlook, Interpersonal Communication, Organization, Compliance Monitoring, Quality Assurance, Electronic Health Records

Industry

Individual and Family Services

Description

UR SPECIALIST – JOIN CAMBER AND MAKE AN IMPACT At Camber Mental Health [https://cambermentalhealth.org/?utm_source=chatgpt.com], we are committed to helping children, youth and families thrive through compassionate, high-quality behavioral healthcare. With an Indeed Work Wellbeing Score of 83, Camber offers a supportive and mission-driven environment where employees can grow while making a meaningful difference every day. JOB SUMMARY The Utilization Review department manages all aspects of a patient’s stay related to initial authorization, concurrent reviews and discharge coordination with health plans. The UR Specialist serves as the primary contact with insurance providers and works closely with admissions, physicians, nurses, therapists and treatment teams to ensure timely, accurate and complete assessments and service coordination for children and youth. This position requires exceptional attention to detail, organization and communication skills in a fast-paced healthcare environment focused on quality care and compliance. SCHEDULE Monday–Friday | 8:00 AM – 5:00 PM HYBRID WORK OPPORTUNITY Candidates may elect to work a hybrid schedule of 2 days in office and 3 days remote after successfully completing their first 90 days in office and receiving a positive 90-day performance evaluation. WHAT YOU’LL DO * Coordinate communication with health plans and insurance companies * Review and manage authorizations and child-specific contracts * Ensure accurate documentation within electronic health records * Compile, summarize and enter clinical and assessment information * Assist with intake assessments and discharge summaries * Support admissions paperwork and utilization review functions * Prepare reports, forms and appeals for insurance providers * Conduct documentation reviews to ensure compliance and quality standards * Assist with audits, quality assurance initiatives and special projects * Maintain strict confidentiality of child, youth and family information * Collaborate with internal teams, referral sources and community partners QUALIFICATIONS EDUCATION * Bachelor’s degree in a human services field preferred, including: * Social Work * Education * Sociology * Psychology * Counseling * Applied Behavioral Sciences * Criminal Justice * High school diploma or GED required LICENSURE/CERTIFICATION * Valid driver’s license * Current auto insurance EXPERIENCE * Minimum two years of experience in: * Case management * Utilization review * Wellness coordination * At least one year working with economically disadvantaged, vulnerable or at-risk youth and/or adults PREFERRED SKILLS * Intermediate Microsoft Office Suite skills including Word, Excel and Outlook * Strong verbal and written communication skills * Excellent organizational and interpersonal abilities * Ability to manage detailed work in a fast-paced environment WHY JOIN CAMBER? * Mission-driven work supporting children and families * Collaborative and inclusive workplace culture * Professional development and ongoing training opportunities * Hybrid work flexibility after successful onboarding period * Monday–Friday schedule with consistent daytime hours * Opportunity to work alongside multidisciplinary healthcare teams * Meaningful career growth in behavioral health services At Camber, employees are expected to lead with authenticity, compassion and collaboration while supporting positive outcomes for children, youth and families. Apply today and become part of a team dedicated to changing lives.

Responsibilities

The UR Specialist manages patient authorizations, concurrent reviews, and discharge coordination with health plans. They serve as the primary contact for insurance providers and collaborate with multidisciplinary teams to ensure accurate clinical assessments.