UTILIZATION - CASE MANAGER (RN/LIC) FT

Fort Duncan Regional Medical Center; Eagle Pass (TX); On-site; USD 70,000 - 100,000; Full time

Job summary

Fort Duncan Regional Medical Center is seeking a Behavioral Health Utilization Management Case Management-Coordinator to support the utilization management process for BH services. The role coordinates authorizations, maintains payer and clinical documentation, and ensures timely reviews in line with payer requirements and organizational policies.

The position emphasizes collaboration with clinical teams, payers, and revenue cycle to assure appropriate levels of care and compliance with

Qualifications

• Bachelor's Degree in Nursing, Counseling, Psychology or Social Work.
• Acute inpatient psychiatric setting as a treatment team member and/or utilization mgmt experience preferred.

Responsibilities

• Coordinates authorization activities and utilization management for Behavioral Health services.
• Maintains payer and clinical documentation and monitors authorization timelines.
• Facilitates communication among clinical teams, payers and revenue cycle departments to ensure appropriate level of care.

Education

Bachelor's Degree: Nursing, Counseling, Psychology or Social Work

Tools

RN License

Licenses: LPC/LMHC/LCSW/LCPC/LPCC

Job description

Responsibilities

The Behavioral Health Utilization Management Case Management-Coordinator supports the utilization management process for BH services provided. This position coordinates authorization activities, maintains accurate payer and clinical documentation, monitors authorization timelines, and facilitates communication among clinical teams, payers and revenue cycle departments. The UM coordinator helps ensure that services are reviewed timely, accurately documented, and provided at the appropriate level of care in accordance with payer requirements, regulatory standards and organizational policies.

EEO Statement

All UHS subsidiaries are committed to providing an environment of mutual respect where equal employment opportunities are available to all applicants and teammates. UHS subsidiaries are equal opportunity employers and as such, openly support and fully commit to recruitment, selection, placement, promotion and compensation of individuals without regard to race, color, religion, age, sex (including pregnancy, gender identity, and sexual orientation), genetic information, national origin, disability status, protected veteran status or any other characteristic protected by federal, state or local laws.

We believe that diversity and inclusion among our teammates is critical to our success.

Notice

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Qualifications

Education:

Bachelor's Degree: Nursing, Counseling, Psychology or Social Work.

Acute inpatient psychiatric setting as a treatment team member and/or utilization mgmt experience preferred.

Licensure/Certification/Registration (List the required and / or preferred licenses, certifications, or registrations, if any)

• Registered Nurse
• Social Work, Marriage and Family, Mental Health Counseling (i.e. LPC, LMHC, LCSW, LCPC, LPCC)