Utilization Specialist at Geisinger Behavioral Health Center Danville, Hudson, WI
Utilization Specialist at Geisinger Behavioral Health Center Danville in Hudson, WI. Apply with swipeandhired.
Job Locations
US-WI-Hudson
Job Post Information* : Posted Date
5 hours ago (11/6/2026 2:07 PM)
ID
2026-114431
# of Openings
1
Job Family
Administrative Support
Location : Name
Burkwood Treatment Center
Overview
PURPOSE STATEMENT:
Proactively monitor utilization of services for patients to optimize reimbursement for the facility .
Responsibilities
ESSENTIAL FUNCTIONS:
- Act as liaison between managed care organizations and the facility professional clinical staff.
- Conduct reviews , in accordance with certification requirements , of insurance plans or other managed care organizations (MCOs) and coordinate the flow of communication concerning reimbursement requirements.
- Monitor patient length of stay and extension s and i nform clinical and medical staff on issues that may impact length of stay.
- Gather and develop statistical and narrative information to report on utilization, non-certified days (including identified causes and appeal information), discharges and quality of services, as required by the facility leadership or corporate office.
- Conduct quality reviews for medical necessity and services provided.
- Facilitate peer review calls between facility and external organizations.
- Initiate and complete the formal appeal process for denied admissions or continued stay.
- Assist the admissions department with pre-certifications of care .
- Provide ongoing support and training for staff on documentation or charting requirements, continued stay criteria and medical necessity updates.
OTHER FUNCTIONS:
- Perform other functions and tasks as assigned.
Qualifications
EDUCATION/EXPERIENCE/SKILL REQUIREMENTS:
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