Utilization Review Coordinator

Responsibilities

Utilization Review Coordinator Opportunity

Please Note this is an onsite position, not remote

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The Utilization Review Coordinator is a key member of the Northstar Behavioral Health Team who is responsible for ensuring that financial benefits are maximized in the treatment and discharge planning for assigned cases through initial and continued stay reviews, prior authorization work for discharge services, effective liaison work and communication between business office and treatment team, support of the discharge plan, and active pursuit of appeals.

Job Duties/Responsibilities

• Conducts concurrent and extended stay reviews on assigned patients in a reasonable time frame, ensuring the information is presented in a concise, articulate manner.
• Schedules upcoming reviews; notifies the attending physician of physician reviews and facilitates reviews if necessary.
• Establishes a good rapport with third party reviewers while maintaining an advocacy stance on behalf of the client; submits any written materials requested by third party payers in a timely manner.
• Is pro-active and independent in gathering information for reviews from the client record and takes the initiative to seek information from members of the treatment team if necessary.
• Notifies all concerned parties when cases are denied, giving recommendation regarding viability of appeal; effectively coordinates collection of all pertinent data to support organization and patient’s position; ensures appeals are prepared within the dictated time constraints.
• Maintains accurate and current records on day’s denied and current status of appeals; demonstrates effective written communication skills in formulating appeals.
• Maintains appropriate records of the utilization review data and activities; updates patient accounting database daily with accurate discharge and certification information; ensures files and records are organized and thorough and easily accessible.
• Participates in formulation of patient’s treatment and discharge plans with other members of the treatment team.
• Maintains on-going contact with insurance reviewers to maintain certification status by providing reviewing insurance with discharge information including outpatient appointments that the patient has post discharge.
• Supports departmental goals by attending and participating in department meetings and offering ideas and suggestions regarding goals and objectives.
  
  

Requirements

Qualifications

• Bachelors degree in a clinical field such as Social Work, Psychology, Human Services, or other related field required.
  
  

North Star Behavioral Health is one of Alaska’s premier mental health facilities offering hope and healing for children, teens and adults who struggle with psychiatric or substance abuse issues. We also offer military-specific care to first responders, service members, veterans and dependents at the Chris Kyle Patriots Hospital. We provide an environment that puts patient care first through excellent care, comfort, and security to the patients and families we treat, at their most vulnerable times. When you work at North Star Behavioral Health, you are never alone, as you are part of a large network of peers and leaders that routinely exchange ideas and review current topics within the industry. With us, you have the opportunity to grow, learn, and advance in your career through robust continuing education opportunities and career advancement with UHS.

BENEFIT HIGHLIGHTS

• Challenging & Rewarding Work Environment
• Competitive Compensation & Generous Paid Time Off
• Excellent Medical, Dental, Vision, and Prescription Drug Plans
• 401(K) with Company Match & Discounted Stock Plan
• SoFi Student Loan Refinancing Program
• Career Development Opportunities within UHS and its 300 Subsidiaries!
• Tuition Assistance
  
  

One of the nation’s largest and most respected providers of hospital and healthcare services, Universal Health Services, Inc. (UHS) has built an impressive record of achievement and performance. Growing steadily since its inception into an esteemed Fortune 500 corporation, annual revenues were $12.6 billion in 2021. During the year, UHS was again recognized as one of the World’s Most Admired Companies by Fortune; and listed in Forbes ranking of America’s Largest Public Companies. Headquartered in King of Prussia, PA, UHS has approximately 89,000 employees and continues to grow through its subsidiaries. Operating acute care hospitals, behavioral health facilities, outpatient facilities and ambulatory care access points, an insurance offering, a physician network and various related services located all over the U.S. states, Washington, D.C., Puerto Rico and the United Kingdom. www.uhs.com

EEO Statement

All UHS subsidiaries are committed to providing an environment of mutual respect where equal employment opportunities are available to all applicants and teammates. UHS subsidiaries are equal opportunity employers and as such, openly support and fully commit to recruitment, selection, placement, promotion and compensation of individuals without regard to race, color, religion, age, sex (including pregnancy, gender identity, and sexual orientation), genetic information, national origin, disability status, protected veteran status or any other characteristic protected by federal, state or local laws.

We believe that diversity and inclusion among our teammates is critical to our success.

Notice

At UHS and all our subsidiaries, our Human Resources departments and recruiters are here to help prospective candidates by matching skillset and experience with the best possible career path at UHS and our subsidiaries. We take pride in creating a highly efficient and best in class candidate experience. During the recruitment process, no recruiter or employee will request financial or personal information (Social Security Number, credit card or bank information, etc.) from you via email. The recruiters will not email you from a public webmail client like Hotmail, Gmail, Yahoo Mail, etc. If you are suspicious of a job posting or job-related email mentioning UHS or its subsidiaries, let us know by contacting us at: https://uhs.alertline.com or 1-800-852-3449.