Senior Utilization Review Specialist
As Senior Utilization Review Specialist, Carly Randall’s goal is to work with insurance companies to ensure patients have proper coverage throughout their stay at La Hacienda.
It is a task that calls upon her best strengths–communicating and organizing.
“I’m really good at developing friendships with the insurance reviewers, making sure we have good close relationships built on integrity and law, then always following through with what we say we’re going to do. Insurance companies trust us and that makes my job easier.”
She uses her organizational skills to work more closely with treatment teams.
“I like implementing strategies to make sure we get the documentation we need in a timely manner, so our patients get the length of stay that they need. I’m a perfectionist when it comes to those types of things.”
The San Antonio native has her own ties to the Kerrville recovery community, having gone through treatment in 2017. She began working at La Hacienda in 2019 in Marketing, moving to Utilization Review in 2021. As a result of those experiences, she has developed a “huge interest” in the lab work and medical treatments.
“I realized how integral that was in getting coverage, so I started developing a fascination with the medical side of things. I find it most interesting.”
This led to her pursuing her Registered Dietician certification, followed by studies in Microbiology.
For Carly, her work is more than just a job.
“I feel emotionally invested in our patients. That helps us develop closer relationships with their case managers and care providers.”
Living in the Hill Country allows her to indulge her love of fitness and the outdoors, where she enjoys hiking, camping, and taking her two rescue dogs to the river.
While studies take a lot of her free time, Carly still volunteers with community organizations such as wildlife rescue.
“Service, whether to myself, to our patients, or to the community, is important to me.”
