Utilization Management Coordinator

Universal Health Services, Inc.; Jeffersonville (IN); On-site; USD 55,000 - 75,000; Full time

Benefits offered by this job

401k plan with company match

Generous Paid Time Off

Tuition Reimbursement potential

Student Loan Repayment

Free meals

Job summary

Wellstone Regional Hospital in Jeffersonville, Indiana, seeks a full-time Utilization/UR Coordinator for its UM Department. The role focuses on executing UR functions, developing case management scenarios, and coordinating with services to ensure effective patient treatment plans.

The position interfaces with managed care organizations, external reviewers, and payers; maintains denials and appeals logs and monitors Medicare audit compliance. Overtime and flexible hours may be required.

Qualifications

• Bachelor's degree in Mental Health/Behavioral Sciences; Master's preferred, or RN licensed in Indiana.
• Minimum of 3 years direct clinical experience in a psychiatric/mental health setting.
• RN licensure required only if RN.
• Overtime and flexible hours may be required.
• Hours: 7:30am-4:00pm and other times as indicated by supervisor.

Responsibilities

• Execute the UR function and implement case management scenarios; consult with services to ensure an effective treatment plan for patients.
• Interface with managed care, external reviewers, and payers for service requests.
• Maintain denials and appeals logs; review progress of appeals activity.
• Oversee compliance with Medicare audits and ensure guidelines are followed.

Skills

Case management

External review liaison

Communication

Interagency coordination

Education

Bachelor's in Mental Health/Behavioral Sciences

Master's preferred

RN in Indiana

Tools

None

Job description

Responsibilities

Wellstone Regional Hospital is a 100-bed acute care facility located in Jeffersonville, Indiana and has been providing quality health care to the residents of Southern Indiana and the Louisville area since 2003. Wellstone specializes in the treatment of Adolescents, Children, Adults, and the CD population. In addition to our in-patient services, we offer out-patient programs as well. Wellstone currently has an opening for a full-time UM Coordinator in the UM Department.

The Utilization Review Coordinator is responsible for executing the UR function, which includes the implementation of case management scenarios, consulting with all services to ensure the provision of an effective treatment plan for all patients. Oversees the response to requests for services and interfaces with managed care organizations, external reviewers, and other payers. Assures that good customer service practices are utilized. Maintains denials and appeals logs and reviews the progress of all appeals activity. Over-see compliance of Medicare audits and assure guidelines are being followed.

Qualifications

QUALIFICATIONS

Education: Bachelor Degree in Mental Health/Behavioral Sciences, Master's preferred, or RN in the state of Indiana.

Experience: A minimum of three (3) years direct clinical experience in a psychiatric or mental health treatment setting. Experience in patient assessment, family motivation, treatment planning and communication with external review organizations or comparable entities.

Licensure: None required unless RN.

Additional Requirements: May be required to work overtime and flexible hours when needed.

Hours of Work: 7:30am-4:00pm and other times as indicated by immediate supervisor.

This opportunity provides the following:

• UHS is Challenging and rewarding work environment
• Growth and development opportunities within UHS and its 400+ subsidiaries
• Competitive Compensation
• 401k plan with company match
• Generous Paid Time Off
• Service Excellence atmosphere!
• Tuition Reimbursement potential
• Student Loan Repayment for certain degrees!!!
• FREE MEALS!

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, UHS today has annual revenues were over $11 billion in 2020. In 2021, UHS was again recognized as one of the World’s Most Admired Companies by Fortune; and listed in Forbes ranking of U.S.’ Largest Public companies. Headquartered in King of Prussia, PA, UHS has more than 89,000 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 U.S. states, Washington, D.C., Puerto Rico and the United Kingdom. www.uhsinc.com.

If any questions about this position, please contact HR Director, Tiffany Pierce, [phone], [e-mail]. WWW.Wellstonehospital.com.

EEO Statement

At UHS and all subsidiaries, our Human Resources departments and recruiters are here to help prospective candidates with matching skillset and experience with the best possible career 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 feel suspicious of a job posting or job-related email, let us know by contacting us at: https://uhs.alertline.com or 1-800-852-3449

Notice

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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.