Utilization Review Specialist: Care Coordination Leader

NeuroPsychiatric Hospitals; Greenwood (IN); On-site; USD 60,000 - 80,000; Full time

Job summary

NeuroPsychiatric Hospitals, Medical Behavioral Hospital of Indianapolis, seeks an experienced Utilization Review Coordinator to oversee services across the care continuum. You will promote effective utilization, monitor resources, and collaborate with multidisciplinary teams to support patients with complex needs.

Required: Bachelor’s in Behavioral Health, Social Work, Counseling, Nursing or Psychology; 2+ years in UR/case management in hospitals.

Qualifications

• Bachelor's in Behavioral Health, Social Work, Counseling, Nursing or Psychology required; Master's degree preferred.
• CCM or ACM certification preferred.
• 2+ years of utilization review or case management experience in a hospital setting.

Responsibilities

• Coordinate patients’ services across the continuum of care by promoting effective utilization and resource management.
• Elaborate with multidisciplinary teams to optimize care plans.
• Document daily in the electronic medical record with accuracy and timeliness.
• Conduct initial precertification with payors and perform concurrent reviews.
• Assist with appeals and report outcomes to the VP of Care Management.
• Ensure compliance with federal/state laws and hospital policies.

Skills

Medication knowledge

Time management

Data entry

Communication skills

Detail oriented

Education

Bachelor's in Behavioral Health, Social Work, Counseling, Nursing or Psychology

Master's degree preferred

CCM certification

ACM certification

Job description

NeuroPsychiatric Hospitals, Medical Behavioral Hospital of Indianapolis, seeks an experienced Utilization Review Coordinator to oversee services across the care continuum. You will promote effective utilization, monitor resources, and collaborate with multidisciplinary teams to support patients with complex needs.

Required: Bachelor’s in Behavioral Health, Social Work, Counseling, Nursing or Psychology; 2+ years in UR/case management in hospitals.