Care Coordination & Utilization Review Specialist

Socket.dev; Crown Point (IN); On-site; USD 55,000 - 75,000; Full time

Benefits offered by this job

Medical Insurance

Dental Insurance

Vision Insurance

401(k) Plan

Employee Assistance Program

Generous PTO

Tuition offers (Capella University)

Job summary

NeuroPsychiatric Hospitals (NPH) is seeking a Utilization Review Coordinator to coordinate patients’ services across the continuum of care, promoting effective utilization and working with multidisciplinary teams. This role requires a Bachelor's in Behavioral Health, Social Work, Counseling, Nursing or Psychology, with 2+ years in utilization review and case management in a hospital setting.

CCM/ACM preferred; BLS/HWC during orientation.

Qualifications

• Bachelor's degree in Behavioral Health, Social Work, Counseling, Nursing, or Psychology required; Master’s degree preferred.
• Minimum of 2 years of utilization review experience in a hospital setting.
• Minimum of 2 years of case management experience, including discharge planning in a hospital setting.

Responsibilities

• Filing documents as needed.
• Initial Precertification with payors.
• Concurrent clinical review with payors.
• Document in the electronic system daily in real time.
• Admission audit.
• Ensure CONs/RONs and CMS certifications are completed by provider.
• Maintain professionalism with staff, patients, and external customers.

Skills

Medication knowledge

Time management

Data entry

Communication skills

Detail oriented

Education

Bachelor's in Behavioral Health

Master's degree preferred

Job description

NeuroPsychiatric Hospitals (NPH) is seeking a Utilization Review Coordinator to coordinate patients’ services across the continuum of care, promoting effective utilization and working with multidisciplinary teams. This role requires a Bachelor's in Behavioral Health, Social Work, Counseling, Nursing or Psychology, with 2+ years in utilization review and case management in a hospital setting.

CCM/ACM preferred; BLS/HWC during orientation.