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Behavioral health and utilization review specialist with 6+ years of experience in mental health, substance abuse treatment, insurance authorizations, case management, and healthcare operations. Skilled in authorization reviews, care coordination, patient advocacy and ability to work collaboratively with clinical teams and insurance providers to secure appropriate levels of care and support successful treatment outcomes.

Motivated and proactive Utilization Review Specialist with exceptional organizational skills and a keen analytical problem-solving ability. Known for being detail-oriented and possessing an articulate communication style. Excels at navigating complex insurance policies and medical necessity criteria, enabling effective advocacy for patients and optimization of care outcomes.

Accomplished, licensed therapist with extensive experience in defining and developing substance abuse, and mental health care strategies and programs. Leading top teams in clinical management, operations management, and project management roles, implementing effective curricula for substance abuse programs, and programs for severely mentally ill children and adults. Entrepreneurial, self-starter, and independent thinker rooted in processes and system development; designs unique sessions pulling from expertise in various forms of therapy, including EMDR. Exceptional communicator and team motivator, with an eye for detail, and an ability to meet clients where they are for true and lasting change. Welcome to major challenges!

Detail-oriented healthcare professional with extensive experience in utilization review and case management, specializing in evaluating medical necessity, ensuring regulatory compliance, and optimizing patient care outcomes. Proven ability to collaborate with interdisciplinary teams, interpret clinical guidelines, and apply evidence-based criteria such as InterQual and MCG to support appropriate level-of-care determinations. Skilled in prior authorizations, concurrent and retrospective reviews, and appeals processes, with a strong commitment to cost-effective, high-quality care. Recognized for strong analytical skills, attention to detail, and effective communication with providers, payers, and patients.

Kristy Fields

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Utilization Review Specialist

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High School Diploma -

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Utilization Review Specialist

High School Diploma -

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