Care Coordination & Utilization Review Specialist

Freedom Behavioral; West Monroe (LA); On-site; USD 55,000 - 75,000; Full time

Benefits offered by this job

Medical

Dental

Vision

401k

Life and Disability

Job summary

Freedom Behavioral Hospital of Monroe is seeking an Utilization Review/Case Manager to coordinate patient care services and manage utilization review functions. You will act as the liaison between the hospital, payors, patients, families, and referral partners to support clinical and financial outcomes.

Responsibilities include securing authorizations, developing discharge plans, documenting activities, and collaborating with external agencies for aftercare.

Qualifications

• Strong understanding of behavioral health levels of care and medical necessity
• Ability to communicate with multidisciplinary teams, payors, patients and families
• Excellent organizational, documentation, and time management skills
• Knowledge of regulatory and accreditation standards for case management and utilization review
• Ability to manage multiple priorities with accuracy and compliance

Responsibilities

• Coordinate with Admissions and Clinical staff to ensure patient needs are met
• Conduct utilization review activities and secure insurance authorizations
• Serve as primary contact with payors for medical necessity and level of care
• Develop and manage discharge plans for safe transitions of care
• Communicate with patients, families, and referral sources to support outcomes
• Present clinical information to the treatment team and participate in meetings
• Maintain communication with physicians, nursing, social services for coordinated care
• Document utilization review and discharge planning in the medical record
• Collaborate with external agencies/providers for aftercare and continuity
• Uphold patient rights, confidentiality, and ethical standards
• Participate in Performance Improvement and Quality Management activities

Skills

Behavioral health

Regulatory compliance

Communication

Discharge planning

Documentation

Job description

Freedom Behavioral Hospital of Monroe is seeking an Utilization Review/Case Manager to coordinate patient care services and manage utilization review functions. You will act as the liaison between the hospital, payors, patients, families, and referral partners to support clinical and financial outcomes.

Responsibilities include securing authorizations, developing discharge plans, documenting activities, and collaborating with external agencies for aftercare.