UR COORDINATOR

UHS • Streamwood, IL

5h • Onsite

About The Position

The Utilization Management Coordinator is responsible for conducting admission and concurrent reviews in accordance with the hospital wide Utilization Management Plan. The UM Coordinator serves as a liaison to 3rd and 4th party reviewers and conducts focused reviews as determined by the Utilization Management Committee. The UM Coordinator maintains all records/data required through the UM Plan and Committee and appeals denied authorizations of dates of services when medical necessity for continued care is evident. The UM Coordinator tracks and reports denials in MIDAS, participates in staff/physician education relative to medical record documentation and actively participates in the UM Committee by tracking data and trends to be reviewed to improve the quality of systems as it relates to the UM Plan. Streamwood Behavioral Healthcare System (SBHS) is a 178-bed acute care facility located in Streamwood, IL, providing mental health treatment to children, adolescents, adults, and their families since 1991. SBHS is a subsidiary of Universal Health Services, Inc. (UHS), one of the nation’s largest and most respected providers of hospital and healthcare services, a Fortune 500 corporation with annual revenues of $13.4 billion in 2022, approximately 94,000 employees, operating acute care hospitals, behavioral health facilities, outpatient facilities, and various related services across the U.S., Washington, D.C., Puerto Rico, and the United Kingdom.

Requirements

• Bachelor's Degree in nursing or Master's Degree in psychology or mental/health/human services field
• Minimum of three (3) years direct clinical experience in a medical-psychiatric, psychiatric or mental health setting
• At least two years’ experience in utilization management

Nice To Haves

• Skills in consumer assessment
• Skills in motivating families and other resources
• Skills in treatment planning
• Skills in communicating with external review organizations or comparable entities
• RN, LCPC, LSW, or LCSW licensure/certification

Responsibilities

• Conduct admission and concurrent reviews in accordance with the hospital wide Utilization Management Plan
• Serve as a liaison to 3rd and 4th party reviewers
• Conduct focused reviews as determined by the Utilization Management Committee
• Maintain all records/data required through the UM Plan and Committee
• Appeal denied authorizations of dates of services when medical necessity for continued care is evident
• Track and report denials in MIDAS
• Participate in staff/physician education relative to medical record documentation
• Actively participate in the UM Committee by tracking data and trends to be reviewed to improve the quality of systems as it relates to the UM Plan

Benefits

• Challenging and rewarding work environment
• Competitive Compensation & Generous Paid Time Off
• Excellent Medical, Dental, Vision and Prescription Drug Plans
• 401(K) with company match and discounted stock plan
• SoFi Student Loan Refinancing Program
• Career development opportunities within UHS and its 300+ Subsidiaries!

What This Job Offers

• Job Type: Full-time
• Career Level: Mid Level
• Number of Employees: 501-1,000 employees