Utilization Review & Care Coordination Case Manager

Freedom Behavioral Hospital of Monroe; West Monroe (LA); Presencial; USD 52.000 - 75.000; Jornada completa

Ventajas ofrecidas por este puesto de trabajo

Medical

Dental

Vision

401k

Life and Disability

Descripción de la vacante

Freedom Behavioral Hospital of Monroe is seeking an experienced Utilization Review/Case Manager to coordinate patient care, manage utilization review functions, and secure insurance authorizations. You will liaise with the hospital, payors, patients, families, and referral partners to support clinical and financial outcomes.

Responsibilities include discharge planning, collaboration with the treatment team, documentation, and participation in PI/QM activities.

Formación

• Strong understanding of behavioral health levels of care, medical necessity criteria, and insurance authorization processes.
• Ability to communicate with multidisciplinary teams, payors, patients, and families in a professional manner.
• Excellent organizational, documentation, and time management skills.
• Knowledge of regulatory and accreditation standards related to case management and utilization review.
• Ability to manage multiple priorities while maintaining accuracy and compliance.

Responsabilidades

• Coordinate with Admissions and Clinical staff to identify and meet patient treatment needs.
• Conduct utilization review activities, securing initial and continued stay authorizations.
• Serve as primary contact with payors, communicating medical necessity and level of care.
• Develop and manage discharge plans for safe transitions of care.
• Communicate with patients, families, and referral sources to support outcomes.
• Present clinical information to the treatment team and participate in meetings.
• Maintain communication with physicians and nursing to ensure coordinated care.
• Document utilization review and discharge planning in the medical record.
• Collaborate with external agencies to coordinate aftercare.
• Uphold patient rights, ethical standards, and confidentiality.
• Participate in Performance Improvement and QM activities including data collection.

Conocimientos

Behavioral health care levels

Medical necessity criteria

Insurance authorization

Descripción del empleo

Freedom Behavioral Hospital of Monroe is seeking an experienced Utilization Review/Case Manager to coordinate patient care, manage utilization review functions, and secure insurance authorizations. You will liaise with the hospital, payors, patients, families, and referral partners to support clinical and financial outcomes.

Responsibilities include discharge planning, collaboration with the treatment team, documentation, and participation in PI/QM activities.