Utilization Review Coordinator

Responsibilities Utilization Review Coordinator- PRN

The Utilization Review Coordinator reviews medical records of patients admitted for psychiatric/mental illness to ensure proper utilization of facility resources, conducts review of patient records to ensure proper case documentation and medical necessity of treatment in accordance with Federal, State, and County regulations; assesses continuing treatment plans and advocates for required patient treatment with medical providers. Serves as a financial liaison between the facility, patient/family and the payor by verifying and securing financial support/commitment for the admission.

MUST HAVE availability to attend an 8- business day Orientation from 8a-4p without interruptions.

Hill Crest Behavioral Health is an acute care, 194 bed inpatient psychiatric facility located in Birmingham, AL, providing mental health services for adolescents and adults. Hill Crest Behavioral Health offers comprehensive benefits, such as:

• Challenging and rewarding work environment • Competitive Compensation & Generous Paid Time Off • Excellent Medical, Dental, Vision and Prescription Drug Plans • 401(K) with company match and discounted stock plan • SoFi Student Loan Refinancing Program • Career development opportunities within UHS and its 300+ Subsidiaries!

More information is available on our Benefits Guest Website: benefits.uhsguest.com

About Universal Health Services

One of the nation's largest and most respected providers of hospital and healthcare services, Universal Health Services, Inc. (UHS) has built an impressive record of achievement and performance. During the year, UHS was again recognized as one of the World's Most Admired Companies by Fortune; and listed in Forbes ranking of America's Largest Public Companies.

Operating acute care hospitals, behavioral health facilities, outpatient facilities and ambulatory care access points, an insurance offering, a physician network and various related services located all over the U.S. States, Washington, D.C., Puerto Rico and the United Kingdom. www.uhs.com

Qualifications

REQUIRED KNOWLEDGE, SKILLS AND ABILITIES

Minimum of a Bachelor's Degree in the area of Counseling, Psychology, or Social Services related field or Nursing BSN or RN.

Strong organizational skills and excellent interpersonal and strong negotiation skills including the ability to communicate clearly and professionally both verbally and in writing.

Prior experience working in a psychiatric inpatient hospital, or outpatient mental health setting, preferably in a residential or acute care.

Ability to communicate and negotiate with psychiatric patients, families of patients, medical staff, ancillary staff and external agency case managers from a patient liaison position.

Computer proficiency to include word processing, spreadsheet, and data collection/management computer programs.

Strong organizational skills and excellent interpersonal and strong negotiation skills including the ability to communicate clearly and professionally both verbally and in writing.

Essential Job Duties/Responsibilities

1. Coordinate with Social Services and Intake Center contacts with patient, family and referral source within twenty-four hours following admission. (15%)
2. Establish scheduled communication with Review Agency to certify treatment regime, patient's need for continued treatment, and negotiate for future levels of care and extended length of stay if needed. (15%)
3. Notify Business Office of any changes in benefit, rate negotiations needed, denials, etc during patient's stay. (15%)
4. Coordinate information between members of the treatment team. (15%)
5. Assure all admissions are reported to review agencies within their required timeframe. (15%)
6. Review each case as insurance dictates for re-certification and continue with completion of the Utilization Management process as required. (10%)
7. Demonstrates competence in medical knowledge and extensive knowledge and command of health insurance plans and managed care benefits. (10%)
8. Performs other duties as assigned/required by this position. (5%)

EEO Statement

All UHS subsidiaries are committed to providing an environment of mutual respect where equal employment opportunities are available to all applicants and teammates. UHS subsidiaries are equal opportunity employers and as such, openly support and fully commit to recruitment, selection, placement, promotion and compensation of individuals without regard to race, color, religion, age, sex (including pregnancy, gender identity, and sexual orientation), genetic information, national origin, disability status, protected veteran status or any other characteristic protected by federal, state or local laws. We believe that diversity and inclusion among our teammates is critical to our success.

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