Utilization Review Coordinator

NeuroPsychiatric Hospitals; Indianapolis (IN); On-site; USD 60,000 - 80,000; Full time

Job summary

NeuroPsychiatric Hospitals is seeking a Utilization Review Coordinator who will manage patient services and collaborate with multidisciplinary teams. The role necessitates a bachelor's degree in a relevant field and significant experience in utilization review and case management. The ideal candidate will demonstrate strong communication skills and attention to detail, ensuring quality care across all patient interactions.

Benefits

Competitive pay rates

Medical, Dental, and Vision Insurance

NPH 401(k) plan with up to 4% Company match

Employee Assistance Program (EAP)

Generous PTO and Time Off Policy

Special tuition offers through Capella University

Work/life balance with great professional growth opportunities

Employee Discounts through LifeMart

Qualifications

• Minimum of 5 years of utilization review experience in a hospital setting required.
• 5 years of case management experience, including discharge planning.
• Certified Case Manager (CCM) or Accredited Case Manager (ACM) preferred.

Responsibilities

• Coordinate patients’ services across the continuum of care.
• Document in the electronic system daily in real time.
• Communicate effectively with staff and patients.

Skills

Detail-oriented

Excellent time management

Data entry

Communication skills

Strong knowledge of medications

Education

Bachelor's degree in Behavioral Health, Social Work, Counseling, Nursing, or Psychology

Master's degree

Job description

About Us

HEALING THE BODY AND MIND

Founded fifteen (15) years ago, NeuroPsychiatric Hospital is the largest hospital system in the nation providing care to patients with both neurological and medical needs. We are unique in that we serve a population which others have been previously unable to, largely due to the patient’s underlying medical issues. Our facilities maintain an inter-disciplinary focus using a multi-specialty approach for both neuropsychiatric and complex medical care issues. This proven approach provides unrivaled quality care for all of our patients. We have multiple locations throughout the United States and are continuing to add locations to ensure better access to our unique model of care.

Overview

NeuroPsychiatric Hospital is looking for a Utilization Review Coordinator to coordinate patients’ services across the continuum of care by promoting effective utilization, monitoring health resources, and collaborating with multidisciplinary teams.

Benefits of joining NPH

• Competitive pay rates
• Medical, Dental, and Vision Insurance
• NPH 401(k) plan with up to 4% Company match
• Employee Assistance Program (EAP)
• Generous PTO and Time Off Policy
• Special tuition offers through Capella University
• Work/life balance with great professional growth opportunities
• Employee Discounts through LifeMart

Responsibilities

• Filing documents as needed
• Initial Precertification with payors
• Concurrent clinical review with payors
• Documenting in the electronic system daily in real time
• Conducting admission audits
• Ensuring that CON’s/RON’s and CMS certifications are completed by providers
• Demonstrating professionalism with all internal and external customers, establishing and maintaining productive working relationships
• Communicating effectively with staff and patients
• Maintaining knowledge of current trends and attending relevant seminars or conferences
• Protecting patient health information according to policies and regulations
• Collaborating with nursing staff, medical staff, and other departments
• Seeking guidance and ensuring compliance with laws and hospital policies
• Adhering to ethical standards and conduct
• Handling reconsiderations, assisting with appeals, arranging peer-to-peer reviews, and reporting outcomes
• Providing education to nursing staff, leadership, and providers regarding documentation
• Working with the business office to resolve appeals/denials and retrospective reviews

Qualifications

Education: Bachelor's degree in Behavioral Health, Social Work, Counseling, Nursing, or Psychology required; Master's degree preferred.

Experience: Minimum of 5 years of utilization review experience in a hospital setting required; 5 years of case management experience, including discharge planning, required.

Licensure: Certified Case Manager (CCM) or Accredited Case Manager (ACM) preferred; Basic Life Support (BLS) and Handle with Care (HWC) certifications obtained during orientation if applicable.

Skills: Strong knowledge of medications, excellent time management, data entry, and communication skills. Must be detail-oriented.