Utilization Review Coordinator

UHS • Attleboro, MA

1d • Onsite

About The Position

Fuller Hospital is a 109-bed licensed, private psychiatric facility located in South Attleboro, Massachusetts providing inpatient and outpatient behavioral health services to residents of Massachusetts and Rhode Island. Inpatient units are designed to treat adults with general psychiatric or intellectual disabilities, as well as adolescents with general psychiatric issues. Patients with co-occurring psychiatric and substance abuse disorders can be treated on most units. Fuller Hospital also provides a less intensive Partial Hospitalization Program (PHP) to patients with psychiatric and co-occurring psychiatric and substance abuse disorders.
The Utilization Review Coordinator is responsible for monitoring the effective and efficient use of health care resources by review of patient admission and continued stay appropriateness in all programs of the hospital. They interact with outside agencies, third party payers, and managed care companies in accordance with contractual agreements, acting as a patient advocate and a representative of the hospital. This is a full time, 40 hour per week position.

Requirements

• Current Massachusetts licensure as a RN, LCSW, LICSW, or LMHC
• One (1) or more years of experience in utilization management, insurance, and/or HMO organization
• Must be able to demonstrate knowledge and skills necessary to provide interventions appropriate to the age of the patients with whom they interact; Demonstrate knowledge of the principles of growth and development over the lifespan, possess the ability to assess data reflective of the patient’s status, and interpret the appropriate information needed to identify each patient’s requirements relative to their age specific needs.

Responsibilities

• Thoroughly reviews the patient’s medical record, assesses the medical necessity for all admissions based on DSM-IV and hospital criteria
• Reviews the patient’s treatment through the course of hospitalization to ensure appropriateness of care
• Documents criteria and reviews findings according to established policy, procedure, and protocols
• Performs other duties as assigned/required by this position

Benefits

• Student Loan Repayment - $200 per month
• Tuition Reimbursement - $5,000 per year
• Challenging and rewarding work environment
• Competitive Compensation & Generous Paid Time Off (26 days per year + roll over)
• Excellent Medical, Dental, Vision and Prescription Drug Plans
• 401(K) with company match and discounted stock plan
• SoFi Student Loan Refinancing Program
• Career development opportunities within UHS and its 300+ Subsidiaries!
• Supervision for Licensure

What This Job Offers

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