Behavioral Health Utilization Review Specialist

6 days ago


Ocala, Florida, United States UHS Full time
Job Summary

We are seeking a highly skilled Utilization Review Coordinator to join our team at The Vines Hospital, a premier behavioral health facility in Ocala, FL. As a Utilization Review Coordinator, you will play a critical role in ensuring the quality and appropriateness of care for our patients.

Key Responsibilities
  • Interface with treatment teams, external case managers, and managed care organizations to obtain required authorizations for all levels of care.
  • Conduct initial and concurrent reviews with insurance companies to ensure compliance with regulatory requirements.
  • Monitor and evaluate records for quality and appropriateness of care.
  • Collaborate with clinical disciplines to ensure seamless care coordination.
Requirements
  • Registered Nurse, LPN, or Bachelor's Degree in Social Work or Psychology with experience in Utilization Review.
  • Excellent communication and computer skills.
  • Ability to work independently and collaboratively with clinical disciplines.
  • Knowledge of regulatory and insurance reimbursement requirements.
About The Vines Hospital

The Vines Hospital is a 26-bed behavioral health facility offering individualized mental health and addiction treatment to adults in a secure and private setting. Our services include partial hospitalization and intensive outpatient programs, as well as acute psychiatric, detox, and PTSD treatment.

We are part of Universal Health Services (UHS), a Fortune 500 company with a reputation for excellence in healthcare services. As a Utilization Review Coordinator at The Vines Hospital, you will be part of a team that is dedicated to providing high-quality care to our patients.



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