Behavioral Health Utilization & Discharge Coordinator

CMC Phoenix; Phoenix (AZ); On-site; USD 60,000 - 85,000; Full time

Job summary

College Medical Center Phoenix is seeking a UR Coordinator to facilitate care across the continuum through effective resource coordination and discharge planning. You will support patients in achieving optimal health and access to care, while ensuring confidentiality per HIPAA regulations.

The role requires Utilization Management and/or behavioral health experience, English communication skills, basic computer knowledge, and an active fingerprint clearance card.

Qualifications

• Utilization Management experience, preferably in a psychiatric setting, for two years, and/or CCM with two years behavioral health experience.
• Two years behavioral health experience and/or previous work in Utilization Management with Medicare/Medicaid payors is highly recommended.
• Able to communicate verbally and in writing in the English language.
• Basic computer knowledge.
• Active level one fingerprint clearance card.

Responsibilities

• Validates the medical necessity of admission and ongoing services of patients and verifies or obtains authorization from third party payors.
• Utilizes needed criteria for admission and continued stay reviews.
• Collects data about the behavioral healthcare status of the patient to determine need and type of care and treatment.
• Identifies levels of treatment and coordinates/assesses continued care and discharge planning, obtaining authorization for next level of treatment when appropriate.
• Documents options in medical records and coordinates with external providers for movement to less restrictive care.
• Ensures compliance with Medicare/Medicaid regulatory requirements for inpatient and outpatient mental health services.
• Completes utilization documentation and CMS forms; pursues reimbursement from payors through appeals.

Skills

Utilization Management experience

Behavioral health experience

English communication

Basic computer knowledge

Fingerprint clearance

Education

Bachelor’s degree in behavioral health

Master’s degree in behavioral health

Certified Case Manager (CCM)

Job description

College Medical Center Phoenix is seeking a UR Coordinator to facilitate care across the continuum through effective resource coordination and discharge planning. You will support patients in achieving optimal health and access to care, while ensuring confidentiality per HIPAA regulations.

The role requires Utilization Management and/or behavioral health experience, English communication skills, basic computer knowledge, and an active fingerprint clearance card.