Utilization & Discharge Coordinator - Psychiatric Care

Summit BHC; Williamsburg (VA); On-site; USD 60,000 - 80,000; Full time

Job summary

Summit BHC is hiring a Utilization Specialist at The Pavilion in Williamsburg, Virginia. This role involves performing and monitoring utilization reviews, ensuring compliance with clinical criteria, and coordinating with insurance providers for treatment approvals. Candidates should have a Bachelor's degree in a relevant field or nursing, with at least two years of clinical experience in a mental health setting. The position is full-time, offering opportunities to support military veterans directly.

Qualifications

• Two or more years of direct clinical experience in a psychiatric or mental health setting.
• Current licensure as an LPN or RN or current clinical professional license in Virginia.

Responsibilities

• Perform admission and retrospective reviews using established hospital criteria.
• Communicate effectively with insurance companies for approval of additional inpatient days.
• Maintain accurate documentation related to utilization management.
• Conduct quality reviews for medical necessity and services provided.

Skills

Clinical experience

Communication with insurance companies

Utilization management

Documentation skills

Education

Bachelor's degree in social work or related field

Graduation from an accredited school of nursing

Job description

Summit BHC is hiring a Utilization Specialist at The Pavilion in Williamsburg, Virginia. This role involves performing and monitoring utilization reviews, ensuring compliance with clinical criteria, and coordinating with insurance providers for treatment approvals. Candidates should have a Bachelor's degree in a relevant field or nursing, with at least two years of clinical experience in a mental health setting. The position is full-time, offering opportunities to support military veterans directly.