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Utilization Review Coordinator
3 months ago
Foundations Behavioral Health is currently hiring a full-time Utilization Review Coordinator to support our UM Department in Doylestown, PA. This is a Monday-Friday full-time position offering full-time benefits and competitive pay.
The Utilization Management Coordinator is responsible for all utilization management activities for assigned cases from admission through discharge, including peer reviews and appeals, in accordance with the Utilization Review Plan, for patient population ages 5 years through 21 years, with significant behavioral health needs and Autism Spectrum Disorders or other developmental disorders.
Position Responsibilities:
- The Utilization Review Coordinator provides support to the program and treatment team in focus and documentation of medical necessity and timely discharge planning.
- Maintains data on utilization management activities and generates required reports, logs, and files as requested.
- Reviews the quality of documentation in the patient record to assure accuracy and to determine that medical necessity criteria is met for the current level of care.
- Assures timely discharge planning, and assists with identification of discharge resources and obtains prior authorization for the next level of care or medication when indicated.
- Facilitates and fully documents physician peer-to-peer reviews, and prepares and submits written appeals in response to denial of initial or continued stay certification.
- Internally, the UM Coordinator will interface with hospital management, staff, and patients.
- Externally, the UM Coordinator will interface with licensing and accrediting agencies, managed care companies, family members, and healthcare treatment agencies.
Benefit Highlights:
- Challenging and rewarding work environment
- Competitive Compensation & Generous Paid Time Off
- 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
- Tuition Reimbursement
Position Requirements
- Master’s degree in social work, counseling, or a related field.
- Experience in a psychiatric setting, preferably inpatient or residential, or experience working in managed care.
- Previous Utilization Review experience highly preferred.
About Universal Health Services
One of the nation’s largest and most respected providers of hospital and healthcare services, Universal Health Services, Inc. (UHS) has built an impressive record of achievement and performance. During the year, UHS was again recognized as one of the World’s Most Admired Companies by Fortune; and listed in Forbes ranking of America’s Largest Public Companies. Operating acute care hospitals, behavioral health facilities, outpatient facilities and ambulatory care access points, an insurance offering, a physician network and various related services located all over the U.S. States, Washington, D.C., Puerto Rico and the United Kingdom.
