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.
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, LPN or MA Level Clinical licence issued by the State of Michigan
Responsibilities
- responsible for the 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!
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What This Job Offers
Job Type
Full-time
Career Level
Mid Level
Education Level
No Education Listed
