Utilization Management Coordinator
UHS•Houston, TX
•Onsite
About The Position
West Oaks Hospital is seeking a dynamic and talented Utilization Management Coordinator to join their team. This role provides administrative case management, conducts admission and continued stay reviews, assists in the appeal of inappropriate reimbursement denials, and participates in the hospital’s Performance Improvement Plan. West Oaks Hospital has been providing psychiatric care for over four decades and offers a broad range of behavioral health programs for children, adolescents, and adults at multiple levels of care.
Requirements
- Bachelor’s Degree in Psychology, Social Work, Nursing or related field, or Associate Degree in Nursing.
- CPR and hospital de-escalation certifications.
- Minimum of one year of case management experience.
- Minimum of one year inpatient psychiatric experience.
Nice To Haves
- Masters degree in human related field.
- TX LVN, RN or LCDC license.
- 5 years of clinical or case management experience.
Responsibilities
- Monitors cases for medical necessity, appropriate duration of service and over or under utilization of resources.
- Completes admission and continued stay reviews with managed care companies and obtains certification.
- Identifies documentation defects.
- Participates in efforts to recover denials.
- Collaborates with medical staff, administration and treatment team.
Benefits
- Student Loan Forgiveness Program
- 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
- Pet Insurance
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What This Job Offers
Job Type
Full-time
Career Level
Mid Level
Number of Employees
501-1,000 employees
