Clinical Utilization Review Coordinator

2 weeks ago


Grand Forks, North Dakota, United States Universal Health Services Full time
Job Summary

We are seeking a highly skilled Utilization Review Coordinator to join our team at Universal Health Services. As a key member of our Behavioral Health team, you will play a critical role in ensuring the efficient and effective delivery of patient care.

Responsibilities
  • Initiate pre-certification calls for private insurance and managed Medicare and Medicaid plans
  • Provide concurrent reviews throughout patient stays to ensure compliance with insurance requirements
  • Track utilization review outcomes and assess the quality of patient progress notes
  • Maintain accurate and up-to-date insurance contact information
  • Manage the insurance appeal process and collaborate with the facilities denial management coordinator
  • Communicate treatment team recommendations and participate in interdisciplinary team meetings
  • Provide resources and suggestions to third-party payors regarding aftercare and discharge continued care
  • Stay informed on legislative and insurance changes affecting continued stay requirements
  • Disseminate pertinent findings and data to referral sources as needed
Requirements
  • Bachelor's degree required
  • At least 3 years of related experience required
Benefits

As a full-time employee of Universal Health Services, you will be eligible for a comprehensive benefits package, including competitive compensation, excellent medical, dental, and vision plans, 401(k) with company match, and opportunities for career development and growth.



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