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Clinical Utilization Coordinator

2 months ago

Sacramento, California, United States UHS Full time
Job Summary

Sierra Vista Hospital is seeking a full-time Utilization Management Coordinator (MSW, MFT, MA, RN, LVN) for the Utilization Management Department.

We are looking for a passionate professional who wants to join a team of dedicated healthcare professionals serving our patients.

Key Responsibilities
  • Manage, review, and monitor patient resource utilization and maximize care effectiveness by evaluating clinical appropriateness.
  • Act as a liaison between payers, business office, and treatment team, providing information and feedback to ensure optimal patient care and reimbursement.
  • Review with payers and obtain authorization for service type and volume through all levels of care and post-care review.
Requirements
  • Education: Bachelor's degree from an accredited university in nursing or a related field, or a master's degree in social work, mental health, or a related field.
  • Experience: A minimum of one (1) year of experience with communication with external review organizations or comparable entities, or four (4) years of direct clinical experience in a psychiatric or mental health setting.
  • Licensure: RN, LCSW, MFT, MSW, LVN/LPT, or applicable licensure.

CPI training is required within the first 30 days of employment. Training is provided by Sierra Vista Hospital.