What are the responsibilities and job description for the Utilization Review Coordinator position at NANA Healthcare Management, LLC?
Southern Live Oak Wellness (SLOW), LLC is an evidence-based, client-centered treatment program that offers clients with all levels of need therapeutic interventions in an environment that is warm and welcoming. SLOW offers PHP, Day and evening IOP, and Residential treatment so that clients can receive care that meets them where they are at and helps them "Be the great person they were always meant to be." We are looking for Utilization Review Coordinators who thrive in a team-based, client-centric environment. Is this you? Read on!
Job Description:
The Utilization Review Coordinator is a vital member of the SLOW Care component of the System of Care. The Utilization Review Coordinator is under the supervision of the Director of UR and is responsible for analyzing patient records to determine legitimacy of admission, treatment, and length of stay in a health-care facility to comply with government and insurance company reimbursement policies.
Location may vary
Pay Rate: $65,000 annually
Type: Full-time
Education:
High School Diploma/GED – AA degree preferred.
Current (five-years) of no felonies or substance abuse convictions.
Experience:
Must have two-years of continuous sobriety prior to hire, if a recovering alcoholic or drug addict and participate in a self-help program.
Knowledge And Training Required at Time of Hire:
- Familiar with American Society of Addiction Medicine (ASAM) and other insurance criteria scoring tools
- High familiarity with medical necessity
- Experience managing mental health and substance authorizations for RTC, PHP, and IOP levels of care
- Ability to work with an interdisciplinary team
- Ability to multitask, work independently, and be proficient with time management
- Experience scheduling peer reviews and coordinating with providers and their schedules
- Ability to answer phone calls, emails, and respond to voicemails in a timely manner
- Moderate working knowledge of psychiatric conditions, medical conditions, psychotropic medications, and reading lab/blood work results
- Ability to build and maintain rapport with clinicians, providers, and payers
Preferred but not required:
Experience managing adolescent authorizations
Experience with Kipu EMR
Experience using online portals such as Availity, ICR, Webpass, etc.
Salary : $65,000
