Utilization Review Coordinator

Universal Health Services; Washington (District of Columbia); On-site; USD 55,000 - 75,000; Full time

Benefits offered by this job

Generous Paid Time Off

Excellent Medical, Dental, Vision and Prescription Drug Plans

401(K) with company match

Tuition Reimbursement and Student Loan Repay Program

Employee Assistant Program (EAP)

Job summary

The Psychiatric Institute of Washington in Washington, DC is seeking candidates for a pivotal role in psychiatric utilization review. This role involves tracking admissions, monitoring documentation, and supporting treatment planning efforts.

The ideal candidate holds a Bachelor's degree in an applicable field and has at least six months of experience in psychiatric utilization review. This position promotes excellence in patient care and documentation among staff, contributing to the hospital's mission for innovative treatment.

Qualifications

• Bachelor’s degree in applicable field of study required.
• Six months psychiatric utilization review experience preferred.
• Candidates must meet hiring criteria including background and drug test.

Responsibilities

• Tracks new admissions or transfers to assigned area.
• Uses Midas for recording reviews and tracking denials.
• Teaches staff to document medical necessity.
• Supports and guides treatment planning as needed.
• Informs department director of changes in managed care.
• Works appropriately and professionally with all staff.
• Arranges schedule considering department needs.
• Performs other job-related duties as assigned.

Job description

Responsibilities

The Psychiatric Institute of Washington is a 152-bed facility with inpatient, outpatient and partial hospitalization programs. Excellence in behavioral health programs for children, adolescents and adults has been the mission of the institute since it opened nearly 50 years ago. As the first and only freestanding psychiatric care facility in Washington, DC, our team is known for providing innovative treatment and care. We strive for excellence, never losing sight of providing patients with hope – hope that although their stay is relatively brief, they may find their way to a brighter future.

• Tracks new admissions or transfers to assigned area and is responsible for knowing and following through with certification requirements from admission through discharge. Serves as liaison to on-site external reviewers.
• Uses Midas for recording reviews and tracking denials. Adds to Midas databases as needed.
• Teaches staff to document medical necessity through in‑services or individual meetings. Monitors quality of records and notifies staff and program director of problems. Available to program director to develop plan for improvement as needed.
• Supports and guides treatment planning as needed. Continues to bring to staff awareness the need for documentation to flow from and correlate with treatment plan.
• Informs department director of changes in managed care companies. Maintains awareness of unique status to propose out‑of‑plan benefits or to open the door to increase hospital’s opportunity to provide services to a larger group.
• Works appropriately and professionally with all staff and demonstrates a supportive attitude toward the goals of the hospital. Makes recommendations for the hospital based on identified trends.
• Arranges schedule in consideration of needs of the department, participates in arranging coverage for planned absences and demonstrates a supportive attitude toward the goals of the department.
• Performs other job related duties as assigned.

Benefit Highlights

• Generous Paid Time Off
• Excellent Medical, Dental, Vision and Prescription Drug Plans
• 401(K) with company match and discounted stock plan
• UHS employee discounted stock option plan
• Tuition Reimbursement and Student Loan Repay Program
• Employee Assistant Program (EAP)
• Life Insurance and Disability Insurances
• Flexible Spending Account
• Pre‑tax Metro SmartTrip Benefits
• Career development opportunities within UHS and its 300+ Subsidiaries!

Qualifications

• Bachelor’s degree in applicable field of study required
• Six months psychiatric utilization review either for hospital or external review organization preferred.
• Candidates must meet the company’s hiring criteria to include a pre‑employment verifications, background investigation and drug test.

COVID Requirements

PIW requires its staff to be fully vaccinated against COVID‑19 (including any booster shots if required), where allowable under the law, unless they are approved for a reasonable accommodation based on disability, medical condition, or religious belief that prevents them from being vaccinated.

E‑VERIFY Statement

PIW participates in E‑Verify. We will provide the Social Security Administration, and if necessary, the Department of Homeland Security, with information from each new employee’s Form I‑9 to confirm work authorization. Please note that we do not use this information to pre‑screen job applicants.

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.

We believe that diversity and inclusion among our teammates is critical to our success.