Utilization Review & Discharge Coordinator

Oceans Healthcare; Dayton (OH); On-site; USD 55,000 - 68,000; Full time

Job summary

Oceans Healthcare in Dayton, OH is seeking an Utilization Review Coordinator to manage UR activities across inpatient, partial hospitalization, and outpatient programs. You will conduct concurrent reviews, verify admission criteria, and coordinate with third-party payers to support appropriate level of care and timely discharge planning.

You will communicate with medical staff, maintain documentation, assist with pre-certifications and appeals, and ensure compliance with Joint Commission and

Qualifications

• Associate’s Degree with emphasis on healthcare or Bachelor’s degree in social services preferred.
• At least one year psychiatric/chemical dependency experience with good working psychiatric/medical knowledge.

Responsibilities

• Identify and report appropriate use, under-use, over-use and inefficient use of services to ensure high quality patient care in the least restrictive environment and in a cost-effective manner.
• Review inpatient, partial hospitalization, and outpatient records to determine appropriateness and clinical necessity of admissions, continued stay, and discharge.
• Notify staff of deficiencies and recommend corrective actions; submit monthly reports to PI Coordinator.

Skills

Assertive communication

Discharge planning

Writing skills

Regulatory knowledge

Patient advocacy

Prioritization

Data analysis

Independence

De-escalation training

Cultural competency

CPR certification

Education

Associate’s degree in healthcare

Bachelor’s degree in social services

Job description

Oceans Healthcare in Dayton, OH is seeking an Utilization Review Coordinator to manage UR activities across inpatient, partial hospitalization, and outpatient programs. You will conduct concurrent reviews, verify admission criteria, and coordinate with third-party payers to support appropriate level of care and timely discharge planning.

You will communicate with medical staff, maintain documentation, assist with pre-certifications and appeals, and ensure compliance with Joint Commission and