Utilization Review Coordinator (UR)
About The Position
As a Utilization Review Coordinator (UR Coordinator), you'll be a vital advocate for our patients, ensuring they receive the best care possible by liaising with external case managers and managed care organizations for certification and recertification of insurance benefits. You'll assist our treatment team in understanding insurance requirements for continued stay and discharge planning and maintain a thorough understanding of patient treatments through constant communication with the team. You will advocate for patient access to services during treatment team meetings and individual physician contact, as well as lead treatment team meetings and continued stay reviews as indicated. Your role is key in guiding patients through their treatment journey and discharge planning, making a real difference every day! Review treatment plans and advocate for additional services. Promote effective use of resources for patients. Maintain contact with physicians and team members. Collaborate on continued stay and discharge planning. Ensure patients are placed in appropriate care levels. Document case management activities and track insurance reviews. Provide patient status updates and insurance requirements to staff. Manage the insurance appeals process and coordinate discharge plans.
Requirements
- Education: A Bachelor’s degree in nursing or a Master’s in social work, mental health, or related field is required.
- Experience: Minimum of two years in behavioral healthcare or managed care, with experience in patient assessment, treatment planning, utilization management, and/or case management and Detox.
Responsibilities
- Liaise with external case managers and managed care organizations for certification and recertification of insurance benefits.
- Assist treatment team in understanding insurance requirements for continued stay and discharge planning.
- Maintain a thorough understanding of patient treatments through constant communication with the team.
- Advocate for patient access to services during treatment team meetings and individual physician contact.
- Lead treatment team meetings and continued stay reviews as indicated.
- Guide patients through their treatment journey and discharge planning.
- Review treatment plans and advocate for additional services.
- Promote effective use of resources for patients.
- Maintain contact with physicians and team members.
- Collaborate on continued stay and discharge planning.
- Ensure patients are placed in appropriate care levels.
- Document case management activities and track insurance reviews.
- Provide patient status updates and insurance requirements to staff.
- Manage the insurance appeals process and coordinate discharge plans.
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
- 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 northstar and yours, anchoring our collective purpose and aspirations
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What This Job Offers
Job Type
Full-time
Career Level
Mid Level
