[Hiring] Utilization Review Coordinator @Meadows of Wickenburg Inc
Role Description As the Utilization Review Coordinator, you will develop and implement systems for authorizations for Inpatient, RTC, PHP and IOP Services. You will conduct pre-certs, concurrent and extended reviews. You will ensure quality documentation of patient care. Responsibilities:
- Utilization Review:
- Provide professional and thorough communication with external representatives to obtain authorization for admission and continued stay.
- Monitor each step of the authorization process to proactively identify potential problems and optimize outcome.
- Minimize the number of cases that need to be referred for psychiatric peer/peer review.
- Interact with patient care staff to assure patient assessment and treatment plan is accurately and consistently reflected in facility documentation.
- Prioritize multiple and various types of case activity, coordinate with UM team to ensure all deadlines are met with highest possible quality of delivery.
- Maintain cumulative documentation regarding action taken during the UR process.
- Conduct reviews to ensure that services and documentation conform to the facility protocols, and the requirements of third-party payer sources.
- Clinical Team Member:
- Interact with patient care staff as noted above.
- Attend treatment staffing and other scheduled meetings to obtain and present information on patient status, care and stay.
- Communicate authorization status, issues or problems to appropriate staff/departments.
- Payer Management:
- Obtain and maintain authorization for each patient. Problem-solve issues relating to stay or service.
- Respond quickly and effectively to requests for information.
- Nurture positive and professional relationships with external (third-party payers) sources.
Qualifications
- Bachelor's degree required
- 3-5 years of experience in utilization review in a behavioral health setting
- Strong communication skills
- Ability to work in a fast-paced environment
Requirements
- We are a Drug Free Company. All positions are designated as Safety Sensitive positions and in light of our company mission, the Company does not employ medical marijuana cardholders.
- Following an offer of employment, and prior to reporting to work, all applicants will be required to submit to and pass a substance abuse screen.
Company Description
Meadows Behavioral Healthcare is a leader in the behavioral health industry. Meadows Behavioral Healthcare offers a range of specialized programs including residential, outpatient and virtual treatment. We provide care for drug and alcohol addiction, trauma, sexual addiction, behavioral health conditions, and co-occurring disorders. We offer state-of-the-art care including neurofeedback and other services. Our evidence-based approach is rooted in decades of clinical experience, with more than 45 years in the field. Our approach is different and success stories from our patients are the proof.