Utilization Coordinator

Cedar Creek Hospital

St. Johns (MI)

On-site

USD 50,000 - 70,000

Full time

7 days ago

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Job summary

Cedar Creek Hospital in Michigan is seeking a Utilization Coordinator to oversee the insurance appeal process and provide UR consultations across the facility. This role partners with the business office to verify coverage and initiate pre-certifications according to policy.

Ideal candidates will have a high school diploma or equivalent, 1–3+ years in a related field, and familiarity with psychiatric utilization review criteria; bachelor's degree with RN/BSW/MSW preferred.

Qualifications

High school diploma or equivalent required; RN/BSW/MSW preferred.
1–3+ years of related field experience.
Experience with psychiatric utilization review criteria preferred.

Responsibilities

Perform financial counseling, insurance verifications, and notify patients about coverage.
Complete insurance pre-certifications as assigned.
Assist the Assessment and Referral Center with pre-certifications as needed.
Complete continued stay reviews with external review agencies as needed.
Provide clinical appropriateness data to UR agencies and insurers.
Analyze patient information to determine length of stay and level of care.

Skills

Utilization review

Insurance verification

Healthcare administration

Clinical reporting

Education

High school diploma or equivalent

Bachelor's degree with RN/BSW/MSW preferred

Job description

Responsibilities

Cedar Creek Hospital of Michigan is a beautiful and state of the art 81-bed facility. Cedar Creek provides evidence-based treatment to adolescents and adults struggling with mental health issues. Cedar Creek Hospital invests in our patients by offering an integrated medicine approach that provides the latest therapies including yoga, mindfulness, aromatherapy, music therapy and nutrition. As part of our success and innovation in the field we are seeking qualified applicants for a Utilization Coordinator position.

Learn more about Cedar Creek Hospital online at: Cedar Creek Hospital

Description

The Utilization Coordinator is responsible for oversight of the insurance appeal process, in collaboration with the business office and for providing UR consultations to other facility departments. Essential job duties include but are not limited to:

Performs financial counseling responsibilities, including insurance verifications and patient/family notification of coverage in coordination with the business office.
Complete insurance pre-certifications as assigned.
Assist the Assessment and Referral Center with pre-certifications as needed.
Complete continued stay reviews with external review agencies as needed.
Provides clinical appropriateness data (verbal and written) to outside utilization review agencies and insurance companies according to policy and procedure.
Analyzes patient clinical information to determine patient length of stay and level or care.

Benefits

Cedar Creek offers an extensive benefits program including Medical (BCBS), Dental (Delta), Vision (VSP), 401k with a company match, Student Loan Repayment of up to $200 per month, Paid Time Off, Disability options, Life insurance, Pet insurance and much more.

About Universal Health Services

Headquartered in King of Prussia, PA, Universal Health Services, Inc. (NYSE: UHS) is one of the nation’s largest and most respected providers of hospital and healthcare services. Since our founding in 1979, UHS has grown steadily into a premier Fortune 500® corporation perennially recognized by multiple esteemed national rating entities. Through its subsidiaries, UHS operates inpatient acute care facilities, inpatient behavioral health facilities, outpatient and other facilities, nationwide virtual behavioral health services, an insurance offering, a physician network and various related services with physical locations in the U.S., Puerto Rico, Ireland and United Kingdom. www.uhs.com.

Qualifications

Requirements

High school diploma or equivalent required, bachelors degree with RN, BSW, or MSW license strongly preferred.
1-3+ years working in a related field required.
Experience working with psychiatric utilization review criteria and program delivery stongly preferred.

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.

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