Demo

Utilization Review Coordinator

Brighter Heights Arizona
Prescott, AZ Full Time
POSTED ON 3/30/2025
AVAILABLE BEFORE 5/26/2025

Why work at Brighter Heights Arizona as a Utilization Review Coordinator?

Brighter Heights Arizona provides therapeutic services for adults with Severe Mental Illness (SMI), with homes in Northern Arizona, as well as child and adolescent therapeutic foster care homes throughout Arizona. Our services are licensed through the Arizona Department of Health Services and accredited through the Joint Commission.

At Brighter Heights Arizona, our goal is that every client and family we serve achieves their optimal potential. We are committed to providing high-quality, therapeutic home environments with support services specially designed to assist our clients in addressing, managing and overcoming serious emotional, psychological and behavioral problems. Please visit our company website for more information https://bh-arizona.com

We offer great benefits for full-time positions. Just a few we listed below:

  • Competitive Compensation
  • Employee Assistance Program
  • Eligible to participate the 401(k)
  • Medical, dental, vision, life insurance, FSA, HSA, and so much more
  • Daily Pay- Benefit for you to access your work wages prior to pay day.

Job Summary:

Coordinating and completing continued stay requests for clients at multiple facilities with varying level of care. Primary liaison between the facilities and various managed care organizations. Organize and maintain data for performance improvement activities by reporting and communicating concerns to the business office.

Job Responsibilities:

  • Verifies eligibility through the AHCCCS portal for our programs in Arizona
  • Maintain and manage a tracking sheet with authorization data
  • Complete all continued stay review paperwork and compiles collateral information for submission
  • Completes telephonic reviews to provide updates to managed care organizations
  • Alerts treatment team of estimated authorization time frames for appropriate discharge planning
  • Review records for medical necessity criteria
  • Works closely with all departments to ensure that documentation and services meet regulatory requirements and to ensure that high quality services are being provided to clients
  • Complete all deliverables to include: notices of admission, notices of discharge, bed holds, and census forms
  • Assists clinical department with tracking active treatment plans
  • Participates in assigned meetings with the team
  • Any other duties as assigned by the supervisor
  • Adheres to Vivant Behavioral Health policies and practices concerning creation, editing, transmission, storage, and disposition of Protected Health Information in compliance with HIPAA.
  • Adheres to the policy and procedures of Vivant Behavioral Healthcare/ Brighter Heights Arizona.

Position Requirements:

  • Possess a Bachelor's Degree in social work, psychology, or similar is preferred, or high school diploma and at least 4 years work experience in behavioral healthcare
  • Must be at least 21 years of age
  • Must have a valid Arizona driver's license
  • Must pass a TB test
  • Ability to obtain a fingerprint clearance card, or in current possession
  • Must pass a full background check and driving record is in good-standing

Skills and Abilities:

  • Knowledge and skill in program/treatment planning and implementation
  • Familiarity with behavioral intervention strategies
  • Knowledge of accepted procedures for individual, group, and family counseling
  • Knowledge of commercial insurance requirements and familiarity with AHCCCS health plans
  • Must have the ability to adjust to a fast-paced environment and follow proper protocols
  • Individual judgment, discretion, and decision-making skills
  • Ability to work independently as well as with others
  • Must be able to communicate effectively
  • Confidentiality and professionalism are essential to this position

Job Type: Full-time

Pay: From $20.00 per hour

Expected hours: 40 per week

Benefits:

  • 401(k)
  • Dental insurance
  • Employee assistance program
  • Health insurance
  • Life insurance
  • Paid time off

Schedule:

  • Day shift
  • Monday to Friday
  • Morning shift

Ability to Commute:

  • Prescott Valley, AZ 86314 (Required)

Ability to Relocate:

  • Prescott Valley, AZ 86314: Relocate before starting work (Required)

Work Location: In person

Salary : $20

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