Clinical Coordinator - Utilization Review
About The Position
The Hampton-Newport News Community Services Board (CSB) is seeking a Clinical Coordinator - Utilization Review to join the Region 5 Reinvestment Initiative. This full-time position plays an important role in ensuring individuals receive timely, appropriate, and effective behavioral health services while supporting regional efforts to improve access to care and coordinate treatment placements. The Clinical Coordinator - Utilization Review conducts utilization reviews of acute and intermediate levels of care, evaluates medical necessity and appropriateness of services, and manages behavioral health bed utilization on a daily basis. This position works closely with hospitals, treatment facilities, CSB staff, and regional partners to support timely movement to the most appropriate level of care.
Requirements
- Master's degree in Human Services or a related field.
- Three (3) years of experience in behavioral health, including utilization management.
Responsibilities
- Conduct utilization reviews of acute and intermediate levels of care to assess medical necessity, appropriateness of treatment, and continued stay criteria.
- Manage and monitor acute care bed availability and placements to support timely and appropriate transitions in care.
- Conduct face-to-face assessments and gather information regarding an individual's treatment needs, progress, and current level of functioning.
- Review treatment progress and outcomes and make recommendations regarding the most appropriate level of care.
- Coordinate communication among hospitals, facilities, CSB staff, and regional partners regarding admissions, continued stays, discharges, and placements.
- Provide guidance and recommendations related to acute, sub-acute, crisis stabilization, and community-based services.
- Monitor consumer placements and assist with identifying appropriate and least restrictive treatment options.
- Communicate findings, recommendations, and utilization concerns to appropriate stakeholders.
- Prepare utilization reports and provide data-driven recommendations to support regional behavioral health planning and resource management.
- Promote quality, cost-effective care while supporting timely access to appropriate services.
- Participate in regional initiatives and activities designed to improve behavioral health system coordination and outcomes.
Benefits
- Health, Vision, and Dental Insurance
- Virginia Retirement System
- Flexible Spending Account (FSA)
- Life Insurance
- 11 Paid Holidays
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What This Job Offers
Job Type
Full-time
Career Level
Mid Level
