Utilization Review Coordinator Jobs

Job Details

Level

Experienced

Remote Type

Fully Remote

Position Type

Full Time

Travel Percentage

No Travel

Job Shift

Regular 8:00 am to 5:00 pm

Job Category

Nurse

Description

This is where you change your story...

At Meadows Behavioral Health we understand that new directions to career advancing and improvement can be scary, but we are excited to offer you a possible new rewarding chapter with us! Come join us in transforming lives!

Who are we?

We have been the most trusted name in the industry and have been helping people for 40 years. Our approach is different and success stories of our patients prove that. We don't have one size fits all treatment and there are no quick fixes.

Who are you?

Are you compassionate, innovative and have a passion to make an impact? Are you looking to get your foot in the door with a company that will believe in your abilities and train you to advance? 75% of our current top-level executive staff are organic internal promotions from within.

We might be a perfect fit for you!

Position Summary:

As the Utilization Review Coordinator you will develop and implement systems for the authorization, concurrent and retrospective review of inpatient admissions and services. May also be involved with writing and facilitating appeals for denied treatment days

Responsibilities:

• Minimize the number of cases that need to be referred for psychiatric peer/peer review. Interact with patient care staff to assure patient assessment and treatment plan is accurately and consistently reflected in facility documentation.
• Provide professional and thorough communication with external representatives to obtain authorization for admission and continued stay. Monitor each step of the authorization process to proactively identify potential problems and optimize outcome.
• Communicate authorization status, issues or problems to appropriate staff/departments.
• Conduct reviews to ensure that services and documentation conform to the facility protocols, and the requirements of third party payer sources.
• Prioritize multiple and various types of case activity; coordinate with UM team to ensure all deadlines are met with highest possible quality of delivery.
• Maintain cumulative documentation regarding actions taken during the UR process.
• Attend treatment staffings and other scheduled meetings to obtain and present information on patient status, care and stay.

Payer Management:

• Nurture positive and professional relationships with external (third party payer) sources.
• Respond quickly and effectively to requests for information.
• Problem-solve issues relating to stay or service.
• Obtain and maintain authorization for each patient.

Qualifications

Education and Experience:

• Prefer a minimum of two years experience in a psychiatric setting or behavioral health utilization review.
• Bachelor/Associates Degree in Nursing preferred or related job experience
• Knowledge of medical terminology, psychiatric interventions and medications and insurance is essential to this position.
• Registered Nursing licensure/certification in good standing (RN) CPR Certification optional.

We are a Drug Free Company. All positions are designated as Safety Sensitive positions and in light of our company mission, the Company does not employ medical marijuana cardholders. Following an offer of employment, and prior to reporting to work, all applicants will be required to submit to and pass a substance abuse screen.

Meadows Behavioral Health is an equal opportunity employer committed to diversity and inclusion in the workplace. Qualified candidates will receive consideration without regard to race, color, religion, sex, sexual orientation, age, national origin, disability, protected veteran status or any other factor protected by applicable federal, state or local laws. Meadows Behavioral Health provides reasonable accommodations to individuals with disabilities and if you need reasonable accommodation during any time of the employment process, please reach out.