COORD - CASE MGMT/UTILIZ REV: Acute Locked Psych Unit - Monday thru Friday Day shift

UHS • Corona, CA

2d • Onsite

About The Position

Utilization Review Coordinator- Psychiatric Unit BONUS at Corona Regional Rehabilitation Hospital in Corona, CA
This a full-time, day shift position working from Monday-Friday 8:00 am - 4:30 pm
The (LVN/LPT) Utilization Review Coordinator in our Psychiatric Unit will be reporting to the Social Services Supervisor and Director of Behavioral Health Services, this position assures oversight and coordination of utilization review activities proactively monitoring documentation and reimbursement for services provided in the inpatient acute psychiatric unit. The Utilization Review Coordinator reviews medical records of patients admitted for psychiatric/mental illness to ensure proper utilization of facility resources, conducts review of patient records to ensure proper case documentation and medical necessity of treatment in accordance with Federal, State, and County regulations; assesses continuing treatment plans and advocates for required patient treatment with medical providers.
The tradition of caring that culminated in the establishment of Corona Regional Medical Center® began in 1965, with the founding of Corona Community Hospital. Since that time the hospital has changed to meet the needs of the rapidly growing community. Corona Community Hospital merged with Circle City Medical Center in 1992 and the resulting entity became Corona Regional Medical Center. The merged hospitals are now a 238-bed community hospital network comprised of a 160-bed acute care hospital and a 78-bed rehabilitation campus. It is certified by The Joint Commission, employs more than 1,250 trained healthcare workers and has a medical staff of approximately 347 physicians representing more than 40 specialties.

Requirements

• Case Managment Expreience Required, minimally one year
• Familiar with the Healthcare Delivery System, Medicare and Medi-Cal reimbursement guidelines; knowledgeable of applicable State, Federal and 3rd party regulations/standards required
• Knowledgeable and experienced with the appeal process
• Excellent verbal and written skills; assertive, persistent and persuasiveness
• Understanding of admission and discharge criteria
• Familiarity with medical terminology, treatment modalities and diagnostic terminology
• Flexible, maintains attention to detail and responsiveness to deadlines
• Strong interpersonal, organizational and time management skills, requiring minimal supervision
• Strong computer skills required
• Significant Utilization Review experience required, minimally one year.
• Assaultive behavior management training (MAB) required within 90 days of hire
• Current Californica License LVN/LPT
• Current CPR Certificate from the American Heart Association

Responsibilities

• assures oversight and coordination of utilization review activities proactively monitoring documentation and reimbursement for services provided in the inpatient acute psychiatric unit
• reviews medical records of patients admitted for psychiatric/mental illness to ensure proper utilization of facility resources
• conducts review of patient records to ensure proper case documentation and medical necessity of treatment in accordance with Federal, State, and County regulations
• assesses continuing treatment plans and advocates for required patient treatment with medical providers

What This Job Offers

• Job Type: Full-time
• Career Level: Mid Level
• Education Level: No Education Listed