Utilization Review Coordinator - Behavioral Health

Universal Health Services; Conway (SC); On-site; USD 65,000 - 90,000; Full time

Benefits offered by this job

Competitive compensation

Generous paid time off

Excellent health plans

401(K) with company match

Student loan refinancing program

Career development opportunities

Job summary

Lighthouse Behavioral Health Hospital, near Myrtle Beach, SC, seeks an Utilization Review Coordinator to oversee UR and quality management activities for psychiatric and dual-diagnosis services.

The role emphasizes admission and discharge planning, insurance benefits management, and adherence to UR policies to ensure appropriate, efficient care. RN license in SC preferred; UR/case management experience valued.

Qualifications

• One to three years of experience in utilization review, case management, or discharge planning.
• Three years of experience in a Behavioral Health facility providing multiple levels of care preferred.
• Prior experience in Medical Records a Plus.

Responsibilities

• Conduct utilization and quality management activities according to UR policies and procedures.
• Promote and maintain high quality care through analysis of clinical criteria related to treatment and LOS.
• Review admission, continued stay, and discharge planning for appropriateness.
• Manage insurance benefits via prospective, concurrent, and retrospective reviews.
• Support discharge planning and continuity of care with existing resources.

Skills

Utilization review

Case management

Discharge planning

Medical records

Education

RN license in SC

Job description

Lighthouse Behavioral Health Hospital, near Myrtle Beach, SC, seeks an Utilization Review Coordinator to oversee UR and quality management activities for psychiatric and dual-diagnosis services.

The role emphasizes admission and discharge planning, insurance benefits management, and adherence to UR policies to ensure appropriate, efficient care. RN license in SC preferred; UR/case management experience valued.