Psychiatric Utilization & Care Coordinator

The Pavilion at Williamsburg Place, Inc.; Williamsburg (VA); On-site; USD 60,000 - 85,000; Full time

Benefits offered by this job

Competitive salary

Comprehensive benefits

Job summary

The Pavilion at Williamsburg Place in Williamsburg, VA is seeking a Utilization Specialist to review admissions, concurrent stays, and discharge planning according to approved criteria to obtain authorizations and support ongoing hospital processes.

This role requires graduation from an approved nursing program or related health field, 2+ years in psychiatric/mental health settings, and current RN or LPN licensure.

Qualifications

• Graduation from an approved/accredited school of nursing or a related health field.
• Two or more years of direct clinical experience in a psychiatric or mental health setting.
• Current licensure as an LPN or RN (or equivalent) in the state where the facility operates.

Responsibilities

• Review admission, concurrent, continued stay, and retrospective cases using approved criteria.
• Communicate with insurers and HMOs for authorization of inpatient days and provide required information.
• Coordinate with physicians and providers on utilization trends and inquiries.
• Assist with pre-certifications and benefit verification with managed care organizations.
• Maintain accurate documentation for utilization management and prepare reports as required.

Skills

Communication

Utilization review

Discharge planning

Interdepartmental coordination

Education

RN or LPN licensure

Nursing degree or related health field

Job description

The Pavilion at Williamsburg Place in Williamsburg, VA is seeking a Utilization Specialist to review admissions, concurrent stays, and discharge planning according to approved criteria to obtain authorizations and support ongoing hospital processes.

This role requires graduation from an approved nursing program or related health field, 2+ years in psychiatric/mental health settings, and current RN or LPN licensure.