Utilization Management Coordinator - LPN

Smokey Point Behavioral Hospital•Marysville, WA

2d•Onsite

About The Position

The LPN Utilization Management Coordinator at Smokey Point Behavioral Hospital plays a pivotal role in contacting external case managers/managed care organizations to obtain insurance benefits certification and recertification throughout the patient’s stay. This role involves reviewing treatment plans, advocating for additional services, promoting effective resource utilization, ensuring patient rights are upheld, maintaining communication with physicians and other team members, collaborating on continued stay and discharge planning, and advocating for the appropriate level of care. The coordinator also interfaces with program staff to facilitate smooth transitions during transfers or discharges.

Requirements

Graduate from an accredited licensed practical nursing program required.
At least two (2) years’ experience in a healthcare setting or managed care company, with experience in patient assessment, treatment planning, utilization management, and/or case management.
Currently licensed to practice by the State of Washington.

Responsibilities

Contact external case managers/managed care organizations to obtain insurance benefits certification and recertification throughout the patient’s stay.
Review the treatment plan and advocate for additional services as indicated.
Promote effective use of resources for patients.
Ensure that patient rights are upheld.
Maintain ongoing contact with the attending physician, program manager, nurse manager, and other team members.
Collaborate with the treatment team on continued stay and discharge planning.
Advocate for the patient to be placed in the appropriate level of care and program.
Interface with program staff to facilitate a smooth transition at the time of transfer or discharge.