TEMP FT UTILIZATION REVIEW COORDINATOR

UHS•Jacksonville, FL

4d•Onsite

About The Position

This position is responsible for monitoring the treatment activities offered to the patient, interfacing with the treatment team/managed care organizations to ensure quality patient care and collaborating with referring professionals for continuity of care. Complete concurrent reviews for mental health and dual diagnosis patients for both inpatient and outpatient services. Complete appeals and follow up on all appeals until a final decision is determined. Must have effective communication skills with treatment team members, physician’s and co-workers throughout the hospital.

Requirements

Registered Nurse, LPN or Master’s level Social Worker.
Experience in Utilization Management, preferred.
Good communication (verbal and written) skills are essential.
Able to work independently and collegially with all clinical disciplines.
Knowledge of regulatory and reimbursement requirements.
Able to monitor and evaluate records for quality and appropriateness of care.
Basic computer skills.

Nice To Haves

Experience in Utilization Management

Responsibilities

Monitoring treatment activities offered to the patient.
Interfacing with the treatment team/managed care organizations to ensure quality patient care.
Collaborating with referring professionals for continuity of care.
Completing concurrent reviews for mental health and dual diagnosis patients for both inpatient and outpatient services.
Completing appeals and following up on all appeals until a final decision is determined.
Communicating effectively with treatment team members, physicians, and co-workers throughout the hospital.