Utilization Review Coordinator

3 weeks ago


Jacksonville, Florida, United States UHS Full time

About the Role:

As a Utilization Review Coordinator at UHS, you will play a critical role in ensuring the quality and appropriateness of patient care. Your responsibilities will include:

  • Monitoring treatment activities and collaborating with the treatment team and managed care organizations to ensure continuity of care.
  • Completing concurrent reviews for mental health and dual diagnosis patients, including inpatient and outpatient services.
  • Processing appeals and following up on all appeals until a final decision is determined.

Requirements:

  • Registered Nurse, LPN, or Master's level Social Worker with experience in Utilization Management.
  • Excellent communication and interpersonal skills, with the ability to work effectively with treatment team members, physicians, and coworkers.
  • Knowledge of regulatory and reimbursement requirements, with the ability to monitor and evaluate records for quality and appropriateness of care.
  • Basic computer skills and proficiency in utilizing electronic health records.

What We Offer:

  • A challenging and rewarding work environment with opportunities for career growth and development.
  • Competitive compensation and generous paid time off.
  • Excellent medical, dental, vision, and prescription drug plans.
  • 401(k) with company match and discounted stock plan.
  • Education reimbursement and assistance.


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