What are the responsibilities and job description for the Utilization Management Coordinator CAS or LAC position at Jefferson Center for Mental Health?
Bonus Opportunity!
At Jefferson Center, it is our policy and our mission to be inclusive and mindful of the diversity of everyone who comes through our doors. We are passionate about building a community where mental health matters and equitable care is accessible to all races, ethnicities, abilities, socioeconomic statuses, ages, sexual orientations, gender expressions, religions, cultures, and languages.
Jefferson Center's Youth Residential Recovery (YRR) mission is to provide intensive substance use disorder treatment in the ASAM Level of Care 3.5 residential treatment setting for Colorado youth ages 13 years of age up to 18.5 years of age.
The Utilization Management Coordinator possesses knowledge of Substance Use Disorders and diagnosis, as well as the ability to articulate those indicators professionally. The UM Coordinator manages medical necessity by evaluating the client medical records to determine the medical necessity concerning the ASAM and determining the appropriateness of level of care. Serves as liaison for clients, referral sources, stakeholders, and insurance companies. Negotiates and advocates for client length of stay and level of care. Oversees utilization review activities to ensure reimbursement for services. The UM Coordinator leads daily treatment team meetings, manages authorizations / reauthorizations and reviews. The UM coordinator must be able to work with the business office and admissions departments to complete preliminary verification of benefits. The UM Coordinator has a working knowledge of all levels of care offered and appropriately manages client benefits.
Essential Duties :
- Manage RAE / insurance / contracts for admissions in cooperation with external stakeholders to ensure all information and processes are completed to support billing, including acquiring pre-authorization and collecting insurance information, including verifying Medicaid Eligibility.
- Provide accurate and detailed billing information in EMR, to include documenting primary and secondary insurance information.
- Ensures compliance with policies, procedures & regulations; maintains quality of records.
- Accurately enter incoming client information into electronic medical record systems.
- Distribute intake information to key individuals.
- Assists in the coordination of Involuntary Commitments and approvals for extended stays, if appropriate.
- Ensure consumers referred to Residential / Inpatient program meet the identified ASAM level of care and that pre-authorizations are approved prior to admission or prior to transfer / discharge to other levels of care.
- Accurately and concisely complete the Census Report for the end of each shift.
- Provide ongoing feedback and information on the status of admissions to clinical team members to coordinate intake and admission efforts.
- Maintain strong customer service including supporting youths and parents who may be in crisis with assistance from other JCMH staff members.
- Is an active team member including assisting in training new staff, advocating for the needs of the team with regard to best serving the clients, and identifying areas for improvement of the admission process.
- Effectively responds to the client / consumer needs and problems, initiates and maintains positive interactions with colleagues and community partners, and exhibits timely response to phone calls, email and other requests.
- Successfully completes all required training in a timely manner & attends key internal meetings as assigned.
- Follow and enforce all Jefferson Centers' Policies and Procedures, including but not limited to confidentiality, sexual harassment / harassment, dual relationships, physical and sexual abuse reporting, Corporate Compliance and Code of Ethics.
Other Duties (Productivity Performance Measures, Professional Growth / Development, Relationships / Communication) :
Note : Employees are held accountable for all duties of this job. This job description is not intended to be an exhaustive list of all duties, responsibilities, or qualifications associated with the job.
Education, Knowledge, Skills & Experience Required :
Salary Grade 14 : $63,800 - $81,200
Additional Salary Information
Youth Residential Recovery Bonus
1,500 1 month anniversary
1,500 6 month anniversary
2,000 1 year anniversary
5,000 Total)
Additional Bonus Information
Application deadline : 2 / 10 / 2025 Review of applications will begin immediately.
Salary : $63,800 - $81,200
