Utilization Review Coordinator

Universal Hospital Services Inc.; Ohio; On-site; USD 10,000 - 60,000; Full time

Job summary

An established industry player is seeking a dedicated Utilization Review Specialist to ensure the highest standards of patient care quality. This role involves conducting thorough reviews of medical records, advocating for residents' treatment needs, and ensuring compliance with regulations. Join a supportive team committed to making a meaningful impact on the lives of youth facing mental health and substance abuse challenges. If you have a passion for advocacy and a keen attention to detail, this position offers a rewarding opportunity to contribute to the wellness and healing journey of residents.

Qualifications

• Bachelor's degree in healthcare or related field is required.
• Strong knowledge of medical records review processes and regulations.

Responsibilities

• Conduct reviews of medical records for treatment compliance.
• Advocate for residents and challenge adverse treatment decisions.

Skills

Attention to Detail

Medical Records Review

Advocacy Skills

Effective Communication

Analytical Skills

Compassion and Empathy

Education

Bachelor's Degree in Healthcare Administration

Bachelor's Degree in Social Work

Bachelor's Degree in Psychology

Job description

Responsibilities

Are you passionate about maintaining the highest standards of patient care quality? We're seeking a dedicated Utilization Review Specialist (URS) to join our team and ensure that the services provided to our facility's residents are in full compliance with established quality standards. If you have a keen eye for detail, a strong understanding of medical records review, and a commitment to advocating for proper treatment, we want to hear from you.

Responsibilities:

• Conduct thorough reviews of medical records for residents undergoing treatment for Alcohol or Other Drugs (AoD) and/or emotional/mental health conditions.
• Verify that treatment utilization aligns with federal, state, and county regulations, ensuring the utmost compliance.
• Assess the ongoing treatment plans to guarantee their appropriateness and effectiveness.
• Take proactive measures to challenge and appeal adverse decisions on behalf of residents.
• Advocate for necessary and required treatment with medical providers, serving as a voice for our residents.
• Consistently follow facility policies and procedures to uphold the highest standards of care.

Qualifications:

• Bachelor's degree in a related field (e.g., healthcare administration, social work, psychology).
• Strong knowledge of medical records review processes and utilization standards.
• Familiarity with federal, state, and county regulations pertaining to patient care.
• Excellent attention to detail and the ability to analyze complex information.
• Effective communication skills for advocating on behalf of residents and collaborating with medical providers.
• Compassionate and empathetic approach when dealing with residents and their treatment needs.

About Us:

Foundations for Living is a secure residential treatment facility designed to address the mental health and substance abuse challenges of youth. With 84 beds, including dedicated accommodations for males and females, we provide a supportive environment for individuals seeking a path towards recovery and improved well-being.

Join our team as a Utilization Review Specialist and make a meaningful impact on the lives of our residents. Your dedication will contribute to their journey to wellness and healing. Apply now to be part of our mission to provide exceptional care and advocacy.

Our mission is to provide an environment of safety where youth feel empowered to heal the wounds of the past and build a foundation of hope for the future.

POSITION SUMMARY

The Utilization Review Specialist (URS) ensures that services provided to facility residents comply with patient care quality standards. Under general supervision, the URS reviews medical records of residents under treatment for AoD and/or emotional or mental illness to ensure proper utilization of treatment in relation to federal, state and county regulations and assesses continuing treatment plans. Appeals adverse decisions on the behalf of the resident and advocates on their behalf for required treatment with medical providers. The Utilization Review Specialist actively and routinely follows facility policies and procedures.