Utilization Specialist
Acadia Healthcare
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- Location
- Norcross, GA
- Posted
- Oct 21
- 1 day ago
Career path
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About the company
Acadia Healthcare
Mental health care · 10,001+ employees
What you'll do
- Act as liaison between managed care organizations and facility professional clinical staff
- Conduct reviews of insurance plans or other managed care organizations
- Monitor patient length of stay and extensions and inform clinical and medical staff
- Gather and develop utilization, non-certified days, discharge and quality information
- 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
What you need
- Required Education: High school diploma or equivalent.
- Preferred Education:Associate's, Bachelor's, orMaster’s degree inSocialWork,Behavioral orMentalHealth,Nursing, or a related health field.
- Experience: Clinical experience is required, or two or more years' experience working with the facility's population. Previous experience in utilization management is preferred
- PreferredLicensure: LPN, RN, LMSW, LCSW, LPC, LPC-Iwithin the state where the facility provides services; or current clinical professional license or certification, as required, within the state wherethe facility provides services.
- CPR and de-escalation and restraint certification required (training available upon hire and offered by facility.
- First aid may be required based on state or facility requirements.
- Education: a high school diploma, an associate degree, a bachelor's degree or a postgraduate degree
Key skills
Utilization managementCPRDe-escalation and restraint certificationClinical experienceMedical necessity
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Read the full posting here
Utilization Specialist
Job Locations
US-GA-Norcross
Job Post Information* : Posted Date
20 hours ago
(10/21/2026 1:03 PM)
ID
2026-112777
# of Openings
1
Job Family
Administrative Support
Location : Name
Lakeview Behavioral Health
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:
Required Education: High school diploma or equivalent.
Preferred Education
:
Associate's, Bachelor's, or
M
aster’s degree in
S
ocial
W
ork
,
B
ehavioral or
M
ental
H
ealth,
N
ursing, or a related health field.
Experience: Clinical experience is required, or two or more years' experience working with the facility's population. Previous experience in utilization management is preferred
LICENSES/DESIGNATIONS/CERTIFICATIONS:
Preferred
Licensure
: LPN, RN, LMSW, LCSW, LPC, LPC-I
within the state where the facility provides services; or current clinical professional license or certification, as required, within the state where
the facility provides services.
CPR and de-escalation and restraint certification required (training available upon hire and offered by facility.
First aid may be required based on state or facility requirements.
ADDITIONAL REGULATORY REQUIREMENTS:
While this job description is intended to be an accurate reflection of the requirements of the job, management reserves the right to add or remove duties from par
ticular jobs when circumstances
(e.g. emergencies, changes in workload, rush jobs or technological developments) dictate.
We are committed to providing equal employment opportunities to all applicants for employment regardless of an individual’s characteristics protected by applicable state, federal and local laws.
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