Utilization Review (UR) Coordinator

Chicago Behavioral Hospital•Des Plaines, IL

9d•$28 - $33•Onsite

About The Position

We are looking for motivated, dependable, and dedicated caregivers to provide exceptional direct care and support to our patients. The Utilization Review Coordinator is responsible for overseeing the Utilization Review Program. This includes the implementation of case management scenarios, consulting with all services to ensure the provision of an effective treatment plan for all patients, oversees the response to requests for services and interfaces with managed care organizations, external reviewers, and other payors. Supervising and supporting performance improvement activities on a daily basis and assure that action is taken as needed and as authorized by organization policies and procedures. Receiving and reviewing department/service performance measures and documentation to evaluate performance improvement activities and coordinate reports of findings to the Quality Council, Medical Executive Committee and Board. Maintain records of the performance improvement performance measures and statistical tools used to describe studies performed or methodology. Advise and assist all departments/services and committees accountable for performance improvement activities and coordinate reports of findings to the Quality Council, Medical.

Requirements

Degree in nursing, social work, mental health/behavioral sciences, or related field required
A minimum of three (3) years direct clinical experience in a psychiatric or mental health treatment setting
One year of managing a related function preferred
Experience in patient assessment, family motivation, treatment planning and communication with external review organizations or comparable entities
May be required to work flexible hours and overtime

Nice To Haves

Master’s degree preferred
LSW, LPS, LCSW, or LCPC or applicable Illinois license preferred

Responsibilities

Overseeing the Utilization Review Program
Implementation of case management scenarios
Consulting with all services to ensure the provision of an effective treatment plan for all patients
Overseeing the response to requests for services
Interfacing with managed care organizations, external reviewers, and other payors
Supervising and supporting performance improvement activities on a daily basis
Assuring that action is taken as needed and as authorized by organization policies and procedures
Receiving and reviewing department/service performance measures and documentation to evaluate performance improvement activities
Coordinating reports of findings to the Quality Council, Medical Executive Committee and Board
Maintaining records of the performance improvement performance measures and statistical tools used to describe studies performed or methodology
Advising and assisting all departments/services and committees accountable for performance improvement activities
Coordinating reports of findings to the Quality Council, Medical