Utilization Management Coordinator - Full-Time/AM Shift (RN)

UHS • Sacramento, CA

92d

About The Position

Sierra Vista Hospital is seeking a Full-time Utilization Management Coordinator (RN) for the Utilization Management Department. If you're passionate about working in the behavioral health setting and have the desire to join a team of healthcare professionals dedicated to serving our patients, we want to hear from you! The candidate must have both UM and Behavioral Health experience. The Sierra Vista Hospital location, a 171-bed psychiatric care facility located in south Sacramento, is a full-service mental health facility and a center of support for patients and their families. Since 1986, we have offered our clinical expertise to those suffering from emotional, behavioral and addiction problems. The Utilization Management Coordinator (RN) is responsible for the managing, reviewing, and monitoring the utilization of resources related to the patient and to maximize effectiveness of care by evaluating clinical appropriateness. The Utilization Management Coordinator functions as liaison between payors, the business office, and treatment team, providing information and feedback to assist in optimum patient care and reimbursement. Utilization Management Coordinator will also review with payor sources and receive authorization for the type and volume of services through all levels of care and aftercare review.

Requirements

• Prefer bachelor’s degree from an accredited college or university in nursing, or master’s degree in social work, mental health, or a related field.
• A minimum of one (1) year experience with communication with external review organizations or comparable entities or four (4) years direct clinical experience in a psychiatric or mental health setting.
• Licensure: RN.
• Trained in Crisis Prevention Intervention (CPI) within the first 30 days of employment.

Responsibilities

• Manage, review, and monitor the utilization of resources related to the patient.
• Maximize effectiveness of care by evaluating clinical appropriateness.
• Function as a liaison between payors, the business office, and treatment team.
• Provide information and feedback to assist in optimum patient care and reimbursement.
• Review with payor sources and receive authorization for the type and volume of services through all levels of care and aftercare review.

What This Job Offers

• Job Type: Full-time
• Education Level: Bachelor's degree
• Number of Employees: 1,001-5,000 employees