Utilization Review Coordinator - Mental Health Services

New York State Office of Mental Health

New York (NY)

On-site

USD 60,000 - 90,000

Full time

7 days ago

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Benefits offered by this job

Insurance (NYS)

Tuition assistance

Career growth opportunities

Paid time off

NYS Retirement programs

Job summary

New York City Children’s Center – Bronx Campus seeks a Utilization Review Coordinator to analyze quality, effectiveness, and efficiency of psychiatric and medical services for individuals with mental illness at the Bronx Campus. State Service candidates may apply and non-competitive promotion options exist.

Responsibilities include reviewing records for completeness, collecting utilization data, and assessing admissions and discharge plans against CMS criteria to ensure necessary and effective

Qualifications

Bachelor’s degree in a human services field and 3 years of utilization review experience or nursing license with 2 years post-licensure experience including utilization review/discharge planning.
Promotes compliance by reviewing records and discharge plans against CMS Utilization Review Standards.

Responsibilities

Review clinical records for completeness and accuracy to ensure compliance.
Collect and analyze data related to utilization review and prepare reports on findings.
Review medical records of admissions, length of stay, and discharge plans against established criteria to determine necessity and effectiveness.

Skills

Utilization review

Data analysis

Education

Bachelor’s degree in human services

Registered Nurse license

Job description

Responsibilities include reviewing records for completeness, collecting utilization data, and assessing admissions and discharge plans against CMS criteria to ensure necessary and effective

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