Utilization Review Coordinator-Behavioral Health

Universal Health Services; Conway (SC, AR); On-site; USD 45,000 - 70,000; Full time

Job summary

An established industry player in healthcare is seeking a dedicated Utilization Review Coordinator to ensure high-quality patient care through systematic review and assessment of healthcare services. This role involves analyzing clinical criteria, managing insurance benefits, and collaborating with discharge planners to facilitate continuity of care. Join a rewarding environment that values your expertise and offers career development opportunities. Your contributions will directly impact the lives of patients in need of psychiatric services, making this a fulfilling career choice.

Benefits

Competitive Compensation

Generous Paid Time Off

Excellent Medical, Dental, Vision Plans

401(K) with company match

Student Loan Refinancing Program

Career Development Opportunities

Qualifications

• 1-3 years experience in utilization review or case management preferred.
• Experience in a Behavioral Health facility providing multiple levels of care preferred.

Responsibilities

• Conduct utilization and quality management activities per policies.
• Review cases for appropriateness of admission and discharge planning.
• Manage insurance benefits through timely review activities.

Skills

Utilization Review

Case Management

Discharge Planning

Clinical Criteria Analysis

Education

Registered Nurse License

Mental Health Clinician License

Job description

Responsibilities

Utilization Review Coordinator Opportunity!

Lighthouse Behavioral Health Hospital, located near beautiful Myrtle Beach, SC, treats adolescents, adults and senior adults in need of psychiatric services, as well as adults who suffer from a chemical dependency, dual diagnosis, or are in need of rehabilitation. Lighthouse offers 24-hour admissions, needs assessment, and referral services.

Position Summary:

The UR Coordinator is responsible for conducting utilization and quality management activities in accordance with Utilization Review policies and procedures. The Coordinator performs the overall function of providing an ongoing, systematic process for the measurement and assessment of the necessity, appropriateness, and efficiency of facility healthcare services and procedures.

• Assisting in the promotion and maintenance of high quality care through the analysis, review, and evaluation of clinical criteria as it relates to patient treatment and length of stay.
• Reviewing cases for appropriateness of admission, continued stay, and discharge planning.
• Managing and effectively utilizing insurance benefits through timely prospective, concurrent, and retrospective review activities.
• Complies with all Administrative, Clinical, and HR policies and procedures.
• Maintains an awareness of patient funding sources, discharge planning needs, and available resources in order to facilitate continuity of care.
• Plans and organizes the functions of the facilities Case Management system to minimize denials of payment.
• Performs prospective, concurrent and retrospective telephonic reviews for inpatient Mental Health and Dual Diagnosis services.
• Promotes alternative care programs and researches available options including costs and appropriateness of patient placement in collaboration with discharge planners and patients.

Benefit Highlights

• Challenging and rewarding work environment
• Competitive Compensation & Generous Paid Time Off
• Excellent Medical, Dental, Vision and Prescription Drug Plans
• 401(K) with company match and discounted stock plan
• SoFi Student Loan Refinancing Program
• Career development opportunities within UHS and its 300+ Subsidiaries!
• More information is available on our Benefits Guest Website: uhsguest.com

About Universal Health Services

One of the nation's largest and most respected providers of hospital and healthcare services, Universal Health Services, Inc. (NYSE: UHS) has built an impressive record of achievement and performance, growing since its inception into a Fortune 500 corporation. Headquartered in King of Prussia, PA, UHS has 99,000 employees. Through its subsidiaries, UHS operates 28 acute care hospitals, 331 behavioral health facilities, 60 outpatient and other facilities in 39 U.S. States, Washington, D.C., Puerto Rico and the United Kingdom.

If you would like to learn more about the Utilization Review Coordinator Position before applying, please contact Shayla Stokely, Director of Human Resources, at [e-mail]

Qualifications

Requirements:

• One to three years of experience in utilization review, case management, or discharge planning preferred.
• Three years of experience in a Behavioral Health facility providing multiple levels of care preferred.
• Registered Nurse or licensed mental health clinician preferred.

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.

Avoid and Report Recruitment Scams

We are aware of a scam whereby imposters are posing as Recruiters from UHS, and our subsidiary hospitals and facilities. Beware of anyone requesting financial or personal information.

At UHS and all our subsidiaries, our Human Resources departments and recruiters are here to help prospective candidates by matching skill set and experience with the best possible career path at UHS and our subsidiaries. During the recruitment process, no recruiter or employee will request financial or personal information (e.g., Social Security Number, credit card or bank information, etc.) from you via email. Our recruiters will not email you from a public webmail client like Hotmail, Gmail, Yahoo Mail, etc.

If you suspect a fraudulent job posting or job-related email mentioning UHS or its subsidiaries, we encourage you to report such concerns to appropriate law enforcement. We encourage you to refer to legitimate UHS and UHS subsidiary career websites to verify job opportunities and not rely on unsolicited calls from recruiters.