Utilization Management and Review Coordinator
About The Position
Southridge Behavioral Hospital is a beautiful and new state-of-the-art facility. As a joint venture with the Trinity Health System and Universal Health Services, we serve up to 96 adult and geriatric patients across four units. We believe that caring, dedicated and valued staff provide exceptional patient care. We are seeking high caliber applicants that will provide innovative and evidence-based care focused on our patient's individual needs, comfort and safety. Thank you for considering our Utilization Management and Review UR Coordinator position as we continue our successful opening! More information about Southridge can be found online at: https://southridgebh.com/ Position Description: The Utilization Coordinator is responsible for the insurance appeal process and for providing utilization consultations to other facility departments. The UR Coordinator reviews and reports verbal and written clinical appropriateness data and discharge information, including discharge plans and medication to external providers. The role coordinates, reviews, and deploys the appeal process in a timely manner when a denial is received. More information is available on our Benefits Guest Website: benefits.uhsguest.com Southridge also has a focus on furthering your Education and Career Development: Career ladder focus with opportunities to cross train, build skills and grow in leadership Tuition reimbursement assistance program Tuition savings through a partnership with Chamberlain University In-house Psychiatric Nurse Residency Transition-to-Practice Orientation (20 CEUs) Career development opportunities across UHS and our 300+ locations! HealthStream online learning catalogue with plenty of free CEU courses Hours and Location: Full-Time. Monday through Friday. We are located on the south side of Grand Rapids, near the intersection of M-6 and Byron Center Ave SW: 6291 Venture Hills Boulevard SW, Byron Center, MI 49315
Requirements
- A minimum of three years' experience working with psychiatric utilization review criteria strongly preferred.
- Knowledge of psychiatric program delivery and utilization review criteria required.
- Registered Nurse or MA Level Clinical licence issued by the State of Michigan
Responsibilities
- insurance appeal process
- providing utilization consultations to other facility departments
- reviews and reports verbal and written clinical appropriateness data and discharge information, including discharge plans and medication to external providers
- coordinates, reviews, and deploys the appeal process in a timely manner when a denial is received
Benefits
- Excellent Medical, Dental, Vision and Prescription Drug Plans
- 401(k) and Roth 401(k) with Company Match
- Employee Stock Purchase Program
- Competitive Compensation & Paid Time Off
- Disability, Life, Pet Insurance and much more!
- Career ladder focus with opportunities to cross train, build skills and grow in leadership
- Tuition reimbursement assistance program
- Tuition savings through a partnership with Chamberlain University
- In-house Psychiatric Nurse Residency Transition-to-Practice Orientation (20 CEUs)
- Career development opportunities across UHS and our 300+ locations!
- HealthStream online learning catalogue with plenty of free CEU courses
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What This Job Offers
Job Type
Full-time
Career Level
Mid Level
Industry
Hospitals
Education Level
No Education Listed
Number of Employees
5,001-10,000 employees
