UTILIZATION REVIEW COORDINATOR

UHS•Washington, DC

90d

About The Position

The Psychiatric Institute of Washington is a152-bed facility with inpatient, outpatient and partial hospitalization programs. Excellence in behavioral health programs for children, adolescents and adults has been the mission of The Psychiatric Institute of Washington since it opened nearly 50 years ago. As the first and only free standing psychiatric care facilities in Washington, DC, our team has a reputation for providing innovative treatment and care. We strive for excellence, never losing sight of providing patients with hope – hope that although their stay is relatively brief, they may find their way to a brighter future.

Requirements

Bachelor’s degree in applicable field of study required
Six months psychiatric utilization review either for hospital or external review organization preferred.
Candidates must meet the company’s hiring criteria to include a pre-employment verifications, background investigation and drug test.
PIW requires its staff to be fully vaccinated against COVID-19 (including any booster shots if required), where allowable under the law, unless they are approved for a reasonable accommodation based on disability, medical condition, or religious belief that prevents them from being vaccinated.
PIW participates in E-Verify. We will provide the Social Security Administration, and if necessary, the Department of Homeland Security, with information from each new employee’s Form I-9 to confirm work authorization. Please note that we do not use this information to pre-screen job applicants.

Responsibilities

Tracks new admissions or transfers to assigned area and is responsible for knowing and following through with certification requirements from admission through discharge. Serves as liaison to on-site external reviewers.
Uses Midas for recording reviews and tracking denials. Adds to Midas databases as needed.
Teaches staff to document medical necessity through in-services or individual meetings. Monitors quality of records and notifies staff and program director of problems. Available to program director to develop plan for improvement as needed.
Supports and guides treatment planning as needed. Continues to bring to staff awareness the need for documentation to flow from and correlate with treatment plan.
Informs department director of changes in managed care companies. Maintains awareness of unique status to propose out of plan benefits or to open the door to increase hospital’s opportunity to provide services to a larger group.
Works appropriately and professionally with all staff and demonstrates a supportive attitude toward the goals of the hospital. Makes recommendations for the hospital based on identified trends.
Arranges schedule in consideration of needs of the department, participates in arranging coverage for planned absences and demonstrates a supportive attitude toward the goals of the department.
Performs other job related duties as assigned.