Utilization Review Coordinator: Care Coordination & Appeals

NeuroPsychiatric Hospitals; Phoenix (AZ); On-site; USD 60,000 - 80,000; Full time

Benefits offered by this job

Competitive pay

Medical/Dental/Vision Insurance

401(k) matching up to 4%

Employee Assistance Program (EAP)

Generous PTO and time off

Capella University tuition offers

Work-life balance and growth

LifeMart employee discounts

Job summary

NeuroPsychiatric Hospitals in Phoenix, AZ is seeking a Utilization Review Coordinator to coordinate patient services across the continuum of care, promote efficient utilization, and collaborate with multidisciplinary teams.

The role requires a Bachelor's in Behavioral Health, Social Work, Counseling, Nursing or Psychology; a Master's degree is preferred. At least 2 years UR and case management experience in a hospital setting is expected, with CCM/ACM preferred and BLS/HWC if applicable.

Qualifications

• Bachelor's degree in behavioral health, social work, counseling, nursing or psychology required.
• Master's degree preferred.
• Minimum of 2 years of utilization review experience in a hospital setting.
• Minimum of 2 years of case management experience, including discharge planning.

Responsibilities

• Coordinate patients' services across the continuum of care.
• Conduct initial precertification with payors and concurrent clinical review.
• Document in the electronic system daily in real time.
• Perform admission audits and ensure CONs/RONs and CMS certifications.
• Maintain professionalism and effective communication with staff and patients.
• Stay current with trends in the field and protect patient health information.
• Assist with appeals, resolutions, and peer-to-peer reviews as needed.
• Educate nursing staff, leadership, and providers on documentation.

Skills

Time management

Data entry

Communication skills

Detail oriented

Medications knowledge

Education

Bachelor's in Behavioral Health

Bachelor's in Social Work

Bachelor's in Counseling

Bachelor's in Nursing

Bachelor's in Psychology

Master's degree

Job description

NeuroPsychiatric Hospitals in Phoenix, AZ is seeking a Utilization Review Coordinator to coordinate patient services across the continuum of care, promote efficient utilization, and collaborate with multidisciplinary teams.

The role requires a Bachelor's in Behavioral Health, Social Work, Counseling, Nursing or Psychology; a Master's degree is preferred. At least 2 years UR and case management experience in a hospital setting is expected, with CCM/ACM preferred and BLS/HWC if applicable.