Utilization Review Coordinator

UHS•Washington, DC

22h•Onsite

About The Position

The Psychiatric Institute of Washington is a 152-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. One of the nation’s largest and most respected providers of hospital and healthcare services, Universal Health Services, Inc. has built an impressive record of achievement and performance. Growing steadily since its inception into an esteemed Fortune 500 corporation, annual revenues were $11.6 billion in 2020. In 2021, UHS was again recognized as one of the World’s Most Admired Companies by Fortune; in 2020, ranked #281 on the Fortune 500; and listed #330 in Forbes ranking of U.S.’ Largest Public Companies. Headquartered in King of Prussia, PA, UHS has 89,000 employees and through its subsidiaries operates 26 acute care hospitals, 334 behavioral health facilities, 39 outpatient facilities and ambulatory care access points, an insurance offering, a physician network and various related services located in 38 U.S. states, Washington, D.C., Puerto Rico and the United Kingdom.

Requirements

Bachelor’s degree in applicable field of study required
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.

Nice To Haves

Six months psychiatric utilization review either for hospital or external review organization preferred.

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.