Utilization Review Coordinator conducts utilization reviews to determine if patients are receiving care appropriate to illness or condition. Monitors patient charts and records to evaluate care concurrent with the patients treatment. Being a Utilization Review Coordinator reviews treatment plans and status of approvals from insurers. Collects and complies data as required and according to applicable policies and regulations. Additionally, Utilization Review Coordinator consults with physicians as needed. May require a bachelor's degree. Typically reports to a supervisor. Typically requires Registered Nurse(RN). The Utilization Review Coordinator contributes to moderately complex aspects of a project. Work is generally independent and collaborative in nature. To be a Utilization Review Coordinator typically requires 4 to 7 years of related experience. (Copyright 2024 Salary.com)
The Utilization Review Coordinator responsibilities include the following:
Overseeing the Utilization Review program for in-patient and residential services. This includes the implementation of case management scenarios, consulting with all services to ensure the provision of an effective treatment plan for all patients, oversees the response to requests for services and interfaces with managed care organizations, external reviewers, and other payers.
Qualified candidates for Utilization Review Coordinator should have the following:
Education: Master's degree in healthcare field preferred
Bachelor's degree in healthcare field is required.
Experience: A minimum of two years (2) years direct clinical experience in a psychiatric or mental health treatment setting, including one year of managing a related function preferred. Experience in patient assessment, family motivation, treatment planning and communication with external review organizations or comparable entities preferred.
Licensure: OPTIONAL
Scheduling:
Our benefits include the following:
To learn more about the company, please visit our website at: https://www.perimeterhealthcare.com
Perimeter Healthcare is one of the leading behavioral health care providers in the country for children, adolescents, adults, and senior adults. We deliver hope to our patients through the delivery of comprehensive and dedicated treatment programs. Our focus and commitment on service excellence is available across several states and in different care settings. Our team ensures our patients receive the required care that they or their loved one needs. We offer several programs for our patients including inpatient acute treatment and residential treatment. We are seeking staff who exhibit daily the following values: C- Compassion A- Accountability R – Respect and E- Empowerment.
EEO
We are committed to providing an environment of diversity and inclusion where equal opportunities are available to all applicants and fellow employees. Perimeter Behavioral Health is an equal opportunity employer regarding all recruitment, training, and selection process within the company regarding race, color, religion, age, sex, sexual orientation, pregnancy, and gender identity, genetic information, national origin, disability status, protected veteran status, or any other characteristic protected by federal, state, or local laws.