Utilization Management Coordinator - Behavioral Health

Universal Health Services; Dover (DE); On-site; USD 60,000 - 80,000; Full time

Job summary

Dover Behavioral Health System in Dover, Delaware, is seeking a dedicated Utilization Management Coordinator to monitor utilization of behavioral health services and optimize reimbursement. This full-time role collaborates with Assessment and Referral Services to ensure accurate admission information and timely review of continuums of care.

You will conduct concurrent and extended stay reviews, prepare appeals, and maintain logs for the Utilization Review department.

Qualifications

• 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 experience as a Utilization Management Coordinator at a long-term care facility.

Responsibilities

• 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.

Skills

Case management

MSW

RN License

Education

MSW or MS in mental health

Registered Nursing License

Job description

Dover Behavioral Health System in Dover, Delaware, is seeking a dedicated Utilization Management Coordinator to monitor utilization of behavioral health services and optimize reimbursement. This full-time role collaborates with Assessment and Referral Services to ensure accurate admission information and timely review of continuums of care.

You will conduct concurrent and extended stay reviews, prepare appeals, and maintain logs for the Utilization Review department.