Behavioral Health UR Coordinator - Career Growth

Universal Health Services, Inc.; Conway (SC); On-site; USD 55,000 - 75,000; Full time

Job summary

Lighthouse Behavioral Health Hospital, located near Myrtle Beach, SC, seeks a Utilization Review Coordinator to oversee utilization and quality management activities for psychiatric services. You will measure necessity, appropriateness, and efficiency of care, focusing on patient treatment and length of stay.

Responsibilities include admissions/continued-stay/discharge reviews, insurance management, and telephonic reviews for Mental Health and Dual Diagnosis services, aiming to minimize denials.

Qualifications

• One to three years of experience in utilization review, case management, or discharge planning preferred.
• Three years in a Behavioral Health facility providing multiple levels of care preferred.
• Prior experience in Medical Records is a plus.

Responsibilities

• Assist in promoting and maintaining high quality care through analysis and evaluation of clinical criteria.
• Review cases for appropriateness of admission, continued stay, and discharge planning.
• Manage insurance benefits through prospective, concurrent, and retrospective reviews.
• Comply with Administrative, Clinical, and HR policies and procedures.
• Support continuity of care by understanding patient funding sources and discharge needs.
• Organize Case Management system within the facility to minimize payment denials.
• Perform telephonic reviews for inpatient Mental Health and Dual Diagnosis services.
• Promote alternative care programs and research options with discharge planners and patients.

Skills

Utilization review

Case management

Discharge planning

Education

Registered Nurse (SC licensure preferred)

Job description

Lighthouse Behavioral Health Hospital, located near Myrtle Beach, SC, seeks a Utilization Review Coordinator to oversee utilization and quality management activities for psychiatric services. You will measure necessity, appropriateness, and efficiency of care, focusing on patient treatment and length of stay.

Responsibilities include admissions/continued-stay/discharge reviews, insurance management, and telephonic reviews for Mental Health and Dual Diagnosis services, aiming to minimize denials.