Utilization Review Coordinator: Impact Behavioral Health

Fuller Hospital; Attleboro, Northern (MA, KY); Hybrid; USD 75,000 - 95,000; Full time

Benefits offered by this job

Student Loan Repayment

Tuition Reimbursement

Paid Time Off 26 days

Medical/Dental/Vision

401K with company match

SoFi Loan Refinancing

Career development

Supervision for Licensure

Job summary

Fuller Hospital is a 109-bed private psychiatric facility located in South Attleboro, MA, providing inpatient and outpatient behavioral health services to MA and RI residents. The Utilization Review Coordinator ensures efficient use of resources by reviewing admissions and stays, liaising with payers, and advocating for patients.

This is a full-time, 40-hour-per-week role. Responsibilities include reviewing medical records for medical necessity, tracking treatment progress, and documenting

Qualifications

• Current Massachusetts licensure as a RN, LCSW, LICSW, or LMHC is required.
• 1+ year of experience in utilization management, insurance, and/or HMO organizations.
• Knowledge of age-appropriate interventions and development over the lifespan.

Responsibilities

• Review patient records to assess medical necessity for admissions based on DSM-IV and hospital criteria.
• Monitor treatment course to ensure appropriateness of care.
• Document criteria and reviews findings according to policy, procedures, and protocols.
• Perform other duties as assigned.

Skills

Massachusetts licensure (RN/LCSW/LICSW

Job description

Fuller Hospital is a 109-bed private psychiatric facility located in South Attleboro, MA, providing inpatient and outpatient behavioral health services to MA and RI residents. The Utilization Review Coordinator ensures efficient use of resources by reviewing admissions and stays, liaising with payers, and advocating for patients.

This is a full-time, 40-hour-per-week role. Responsibilities include reviewing medical records for medical necessity, tracking treatment progress, and documenting