Utilization Management Coordinator

Dover Behavioral; Dover (DE); On-site; USD 55,000 - 75,000; Full time

Job summary

Dover Behavioral Health System, a 104-bed acute care psychiatric hospital in Dover, Delaware, is seeking a full-time Utilization Management Coordinator. The role focuses on monitoring utilization and optimizing reimbursement, with responsibilities across admission reviews, concurrent reviews, and appeals.

Qualified candidates will hold an MSW or MS in a mental health field or a Registered Nursing License, plus at least one year of case management or hospital experience; preferred: prior UM

Qualifications

• Minimum: MSW or MS in a recognized mental health field or a Registered Nursing License.
• One year experience in case management and/or hospital experience.
• Preferred: one year as a Utilization Management Coordinator at a long-term care facility.

Responsibilities

• Conduct admission reviews with Assessment and Referral Services to ensure up-to-date admissions information.
• Perform concurrent and extended stay reviews at appropriate intervals.
• Prepare and submit appeals to third-party payors, collecting necessary data for hospital and patient support.
• Ensure timely communication of discharge information to insurance companies within 24 hours and maintain logs for the Utilization Review department.

Skills

Case management

Utilization management

Hospital experience

Education

MSW or MS in mental health

Registered Nursing License

Job description

Responsibilities

Dover Behavioral Health System is a 104-bed, acute care psychiatric hospital located in the beautiful Dover, Delaware area. Dover Behavioral Health System features individual units for adolescents and adults and offers inpatient acute care, partial hospitalization, and intensive outpatient programs. On average, over 10,000 patients receive care from our compassionate health care team each year at Dover Behavioral Health System. This opportunity offers working at a hospital known for its outstanding patient satisfaction, including ranking 6th for highest patient satisfaction in 2020 compared to over 200+ psychiatric hospitals. We attribute this success to our talented and dedicated staff. We are the best at what we do!

Dover Behavioral Health system is seeking qualified candidates for our Utilization Management Coordinator - Full-Time position. In this role, you will proactively monitor utilization of continuum services and optimize reimbursement.

Responsibilities will include:

• Conduct admission reviews in collaboration with Assessment and Referral Services to ensure up-to-date admissions information.
• Perform concurrent and extended stay reviews at appropriate intervals.
• Prepare and submit appeals to third-party payors, collecting necessary data for hospital and patient support.
• Ensure timely communication of discharge information to insurance companies within 24 hours, and maintain updated logs and records for the Utilization Review department.

Qualifications

Minimum:

• MSW or MS in a recognized mental health field or a Registered Nursing License
• One (1) year experience in case management and/or hospital experience

Preferred:

• One (1) year experience as a Utilization Management Coordinator at a long-term care facility

About Our Parent Company (Universal Health Services):

One of the nation’s largest and most respected providers of hospital and healthcare services, Universal Health Services, Inc. (UHS) has built an impressive record of achievement and performance. During the year, UHS was again recognized as one of the World’s Most Admired Companies by Fortune; and listed in Forbes ranking of America’s Largest Public Companies. Operating acute care hospitals, behavioral health facilities, outpatient facilities and ambulatory care access points, an insurance offering, a physician network and various related services located all over the U.S. States, Washington, D.C., Puerto Rico and the United Kingdom. www.uhs.com

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.