Utilization Management Coordinator

West Oaks Hospital; Houston (TX); On-site; USD 50,000 - 80,000; Full time

Job summary

An established industry player in psychiatric care is seeking a dedicated Utilization Management Coordinator to enhance patient care and optimize resource utilization. This full-time role involves administrative case management, conducting reviews, and collaborating with medical professionals to ensure compliance and quality of care. The ideal candidate will possess strong analytical skills and a background in healthcare management. Join a compassionate team dedicated to making a difference in the lives of patients while enjoying a rewarding work environment with ample career development opportunities.

Benefits

Student Loan Forgiveness Program

Competitive Compensation

Generous Paid Time Off

Excellent Medical, Dental, Vision Plans

401(K) with Company Match

Career Development Opportunities

Qualifications

• Bachelor's degree in a relevant field is required; Master's preferred.
• 1+ years of case management and inpatient psychiatric experience required.

Responsibilities

• Monitor cases for medical necessity and service duration.
• Conduct admission and continued stay reviews with managed care companies.

Skills

Case Management

Medical Necessity Monitoring

Collaboration with Medical Staff

Documentation Review

Education

Bachelor’s Degree in Psychology

Bachelor’s Degree in Social Work

Bachelor’s Degree in Nursing

Master’s Degree in a Human-Related Field

Tools

Hospital Management Software

Job description

Utilization Management Coordinator - Full-time Opportunity

West Oaks Hospital has provided psychiatric care to the Houston area and surrounding communities for over four decades. Our 176-bed acute care facility is fully accredited and includes a 16-bed residential treatment center for adult chemical dependency.

We offer a broad range of behavioral health programs for children, adolescents, and adults. Treatment is offered at multiple levels of care including inpatient, partial hospitalization, and intensive outpatient.

We are available 24 hours a day, seven days a week to assist you and answer your questions about treatment options and insurance coverage. The hospital is easily accessible off the Southwest Freeway near the Galleria.

Visit us online at: https://westoakshospital.com/

West Oaks Hospital is seeking a dynamic and talented Utilization Management Coordinator to join our team of compassionate, dedicated professionals. The Utilization Management Coordinator provides administrative case management, conducts admission and continued stay reviews, assists in the appeal of inappropriate reimbursement denials, and participates in the hospital’s Performance Improvement Plan.

Job Duties/Responsibilities:

• Monitors cases for medical necessity, appropriate duration of service, and over or under utilization of resources.
• Completes admission and continued stay reviews with managed care companies and obtains certification.
• Identifies documentation defects.
• Participates in efforts to recover denials.
• Collaborates with medical staff, administration, and treatment team.

Benefit Highlights:

• Student Loan Forgiveness Program
• Challenging and rewarding work environment
• Competitive Compensation & Generous Paid Time Off
• Excellent Medical, Dental, Vision, and Prescription Drug Plans
• 401(K) with company match and discounted stock plan
• SoFi Student Loan Refinancing Program
• Career development opportunities within UHS and its 300+ Subsidiaries
• More information is available on our Benefits Guest Website: uhsguest.com

About 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. Growing steadily since its inception into an esteemed Fortune 500 corporation, annual revenues were $14.3 billion in 2023. 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.

Headquartered in King of Prussia, PA, UHS has approximately 96,700 employees and continues to grow through its subsidiaries. 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

Qualifications

Requirements:

• Education Required: Bachelor’s Degree in Psychology, Social Work, Nursing, or related field, or Associate Degree in Nursing. Preferred: Master’s degree in a human-related field.
• Licensure and certification Required: CPR and hospital de-escalation certifications. Preferred: TX LVN, RN, or LCDC license.
• Experience Required: Minimum of one year of case management experience and one year of inpatient psychiatric experience. Preferred experience: 5 years of clinical or case management experience.

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

At UHS and all our subsidiaries, our Human Resources departments and recruiters are here to help prospective candidates by matching skillset and experience with the best possible career path at UHS and our subsidiaries. We take pride in creating a highly efficient and best-in-class candidate experience. During the recruitment process, no recruiter or employee will request financial or personal information (Social Security Number, credit card, or bank information, etc.) from you via email. The recruiters will not email you from a public webmail client like Hotmail, Gmail, Yahoo Mail, etc. If you are suspicious of a job posting or job-related email mentioning UHS or its subsidiaries, let us know by contacting us at: https://uhs.alertline.com or 1-800-852-3449.