Utilization Review Coordinator (UR)
About The Position
The Utilization Review (UR) Coordinator is responsible for contacting external case managers/managed care organizations for certification and recertification of insurance benefits throughout the patient’s stay as well as assists the treatment team in understanding the insurance company’s requirements for continued stay and discharge planning. The UR Coordinator is responsible for having a thorough understanding of the patient’s treatment through communication with the treatment team. The UR Coordinator advocates for the patient’s access to services during treatment team meetings and through individual physician contact. The UR Coordinator chairs the treatment team meetings and completes medical necessity reviews as indicated.
Requirements
- Degree in nursing, social work, mental health/behavioral sciences, or related field required
- A minimum of two (2) years’ experience in a healthcare setting or managed care company, with experience in patient assessment, treatment planning, discharge planning, utilization management, and/or case management
Nice To Haves
- Master’s degree preferred
Responsibilities
- Contacting external case managers/managed care organizations for certification and recertification of insurance benefits throughout the patient’s stay
- Assisting the treatment team in understanding the insurance company’s requirements for continued stay and discharge planning
- Having a thorough understanding of the patient’s treatment through communication with the treatment team
- Advocating for the patient’s access to services during treatment team meetings and through individual physician contact
- Chairing the treatment team meetings
- Completing medical necessity reviews as indicated
Benefits
- 401(k) + matching
- Health insurance
- 100% company-paid life insurance coverage up to 2x your annual salary
- Vision insurance
- Dental insurance
- 100% company-paid long term disability insurance
- Paid time off
- Paid holidays
- Cafeteria on site + discounted meals
- Employee engagement events
- Employee assistance program
- Employee recognition program
- Free parking
- Career & training development opportunities
- Dynamic and inclusive work environment
- Engaged management team dedicated to your success
- A guiding mission and set of values that serve as both our north star and yours, anchoring our collective purpose and aspirations
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What This Job Offers
Job Type
Full-time
Career Level
Entry Level
Number of Employees
101-250 employees
