Utilization Management Coordinator-PRN

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

Job summary

An established industry player in psychiatric care is looking for a dedicated Utilization Management Coordinator. This role involves administrative case management, conducting reviews for admissions and continued stays, and collaborating with medical staff to ensure optimal patient care. You will be part of a team that is committed to providing high-quality behavioral health services. This position offers a rewarding work environment with opportunities for career development within a large healthcare organization. If you are passionate about making a difference in patients' lives, this role is perfect for you.

Benefits

Challenging and rewarding work environment

Competitive Compensation

Career development opportunities

Qualifications

• Minimum of one year of case management and inpatient psychiatric experience required.
• Bachelor’s degree in Psychology or Nursing preferred.

Responsibilities

• Conducts admission and continued stay reviews with managed care companies.
• Monitors cases for medical necessity and resource utilization.

Skills

Case Management

Psychiatric Care

Medical Necessity Monitoring

Collaboration

Education

Bachelor’s Degree in Psychology

Associate Degree in Nursing

Master’s Degree in a Human-Related Field

Tools

CPR Certification

Hospital De-Escalation Certification

Job description

Responsibilities

Utilization Management Coordinator - PRN 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.

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 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:

• Challenging and rewarding work environment
• Competitive Compensation
• Career development opportunities within UHS and its 300+ Subsidiaries

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 $15.8 billion in 2024. UHS was again recognized as one of the World’s Most Admired Companies by Fortune; listed in Forbes ranking of America’s Largest Public Companies. Headquartered in King of Prussia, PA, UHS has approximately 99,000 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 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.