Utilization Review Coordinator — Mental Health Case Management

Chicago Behavioral Hospital; Des Plaines (IL); On-site; USD 60,000 - 69,000; Full time

Benefits offered by this job

401(k) + matching

Health insurance

Life insurance

Vision insurance

Dental insurance

Paid time off

Paid holidays

Employee engagement programs

Employee assistance program

Free parking

Job summary

Chicago Behavioral Hospital in Des Plaines, IL is seeking a Utilization Review Coordinator to oversee the Utilization Review Program, implement case management scenarios, and coordinate with services to ensure effective treatment plans.

The role interfaces with managed care, external reviewers, and payors; it also supports performance improvement activities, reviews department performance data, and reports findings to the Quality Council and Medical Executive Committee.

Qualifications

• Degree in nursing, social work, mental health/behavioral sciences, or related field required; Master’s degree preferred.
• Minimum of 3 years direct clinical experience in a psychiatric/mental health setting.
• Experience with patient assessment, treatment planning, and liaison with external review organizations.

Responsibilities

• Oversee the Utilization Review Program and case management scenarios.
• Consult with services to ensure effective treatment plans for all patients.
• Interface with managed care organizations, external reviewers, and payors.
• Supervise performance improvement activities and ensure policy compliance.
• Review performance measures and report findings to Quality Council and Medical Executive Committee.

Skills

Clinical assessment

Treatment planning

Communication with external review org

Performance improvement

Case management

Education

Degree in nursing, social work, mental health/behavioral sciences, or related field

Master’s degree preferred

Tools

Licensure: LSW/LCSW/LCSW/LCPC or IL license preferred

Job description

Chicago Behavioral Hospital in Des Plaines, IL is seeking a Utilization Review Coordinator to oversee the Utilization Review Program, implement case management scenarios, and coordinate with services to ensure effective treatment plans.

The role interfaces with managed care, external reviewers, and payors; it also supports performance improvement activities, reviews department performance data, and reports findings to the Quality Council and Medical Executive Committee.