UR COORDINATOR

UHS•Horsham Township, PA

11d

About The Position

The Horsham Clinic is seeking a Utilization Review Coordinator for its 206-bed private behavioral healthcare facility on a 55-acre suburban campus in Ambler, Pennsylvania. The clinic provides behavioral health services to children, adolescents, adults, and families, with additional satellite day hospital programs in Pennsylvania, Delaware County, and Chester County. The Utilization Review Coordinator evaluates medical records to assess the severity of patients’ illnesses and determine appropriate levels of care. The coordinator serves as a liaison between patients, the hospital, and insurance companies, advocating and negotiating for appropriate lengths of stay and levels of care. The role also oversees utilization review activities with other departments to help ensure reimbursement for hospital services.

Requirements

Master’s-level education or MSW.
Pennsylvania RN license.
LSW or LCSW licensure.
Working knowledge of behavioral mental health, nursing clinical practices, and management.
Experience interviewing patients and families to obtain clinical information and information about acute symptoms.
Highly developed written and verbal communication skills.
Three or more years of experience in a behavioral health setting.
Ability to plan, direct, and monitor others’ activities, with demonstrated leadership abilities that contribute to a positive work environment.
Proficiency with common computer-based applications, including email, word processing, and databases.
Willingness to work with children and adolescents.
Ability to work in an environment with psychiatric patients who may exhibit violent or aggressive behavior.

Responsibilities

Evaluate medical records to determine the severity of patients’ illnesses and appropriate levels of care.
Serve as a liaison for patients and the hospital with insurance companies.
Negotiate and advocate for patients’ length of stay and level of care.
Oversee utilization review activities with other departments to ensure reimbursement for services provided by the hospital.
Plan, direct, and monitor the activities of others.