Utilization Review Coordinator - Healthcare Support (Temp)

Odyssey Behavioral Group; Franklin (TN); On-site; USD 42,000 - 56,000; Full time

Benefits offered by this job

Career development

CE & certifications

Health plan options

Dental & vision options

Employee Assistance Program

Life & ADD paid by company

401K with company match

HSA, FSA, DSA accounts

Referral program

Parental leave

Job summary

Odyssey Behavioral Healthcare, LLC is seeking an experienced Utilization Review Coordinator in Franklin, TN for a 4-month assignment. You will monitor health care resource use by reviewing admissions and ongoing stays, collaborating with payers, and advocating for patients within contractual guidelines.

This role requires a Bachelor's degree and at least one year of clinical experience in a mental health setting, plus a valid driver's license.

Qualifications

• Bachelor's degree and 1 year clinical mental health experience.
• Valid driver's license and vehicle insurance.
• Experience in a mental health facility setting preferred.

Responsibilities

• Set reviews to ensure compliance with criteria, medical policy, and member eligibility.
• Conducts initial pre-certification authorizations, continued stay reviews, care coordination, and discharge planning for appropriateness of treatment.
• Assesses the medical necessity of client appropriateness of treatment setting to determine the level of care required.
• Facilitates member care transition through the healthcare continuum and refers treatment plans/plan of care to clinical reviewers as required.
• Inputs and maintains authorization status in the appropriate EMR systems for billing purposes
• Consults with clinical reviewers and/or medical directors to ensure medically appropriate, high quality, care throughout the medical management process.
• Utilizes the applicable documentation methods needed to communicate effectively with the medical and clinical team(s).
• Provides staff with appropriate providers, programs, or community resources.
• Collaborates with providers to assess members' needs for early identification and proactive discharge planning.
• Facilitates Peer Reviews when needed.
• May manage appeals for services denied.
• Assists with verifying insurance coverage, when needed.
• Participates in and facilitates facility and department meetings, as needed.

Education

Bachelor's degree

Job description

Odyssey Behavioral Healthcare, LLC is seeking an experienced Utilization Review Coordinator in Franklin, TN for a 4-month assignment. You will monitor health care resource use by reviewing admissions and ongoing stays, collaborating with payers, and advocating for patients within contractual guidelines.

This role requires a Bachelor's degree and at least one year of clinical experience in a mental health setting, plus a valid driver's license.