What are the responsibilities and job description for the UR COORDINATOR/CASE MANAGER position at SandyPines Residential Treatment Center?
Responsibilities:
The UR/Case Manager performs concurrent reviews with insurance companies for continued stay for residents. Assures optimum quality of patient care in the most cost-effective manner. Works closely with both Utilization Review and Social Service's Department to ensure quality of patient care.
Qualifications:
About Universal Health Services
Notice
SandyPines Residential Treatment Center is a 149-bed Residential Psychiatric Facility servicing children and adolescents ages 5 to 17. The facility is in beautiful South Florida, nestled beside Jonathan Dickinson State Park and just minutes away from the shores of the Atlantic Ocean. We are the largest treatment center of its kind in the southeast and host Riverbend Academy, an accredited school on our campus.
Much more online at: sandypineshospital.com
The UR/Case Manager performs concurrent reviews with insurance companies for continued stay for residents. Assures optimum quality of patient care in the most cost-effective manner. Works closely with both Utilization Review and Social Service's Department to ensure quality of patient care.
Essential Job Duties:
- Performs concurrent reviews on a daily basis
- Performs case management duties, i.e. referrals for aftercare services, collaborates with all parties of the treatment team
- Ensures discharge planning is completed for all residents
- Liaison between treatment team, referral source, community agencies, court officials, outside therapists; maintains the integrity of the medical record of assigned residents; leads specific treatment team meetings;
- Maintains records of the review process, following the facility UR Plan
- Communicates any concurrent review complications to Administration
- Performs current case review complications with insurance companies as scheduled
- Initiates denial letters as indicated by the facility UR Plan
- Informs attending physicians at any time during stay if there are complications with continued stay
- Ensure appropriate parties are notified in event of continued stay denial
- Appeals all denials within allotted timeframe
- Maintains accurate logs and record
Job Requirements:
- Education: Bachelor’s degree in Psychology, Mental Health Counseling, Social Work, Nursing or any related field required.
- Minimum of 2 years of experience needed working in a psychiatric or substance abuse setting: 3-5 years of experience in case management and/or utilization review in the psychiatric field preferred.
- License/Certification: Not required.
- Skills: Good oral and written communication skills required to communicate in a clear and concise manner with patients, physicians, staff and administration. Stable emotional makeup required to work in a fast paced environment with frequent interruptions
- Physical Requirements: Work is sedentary requiring sitting most of the day. Sitting at least six hours a day while processing paperwork, and answering phones. Lifting up to 20 pounds of copier paper from floor level to check level while filling copier paper
Benefits
- Competitive Compensation & Generous Paid Time Off
- Excellent Medical, Dental, Vision and Prescription Drug Plans
- 401(K) with company match and discounted stock plan
About Universal Health Services
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 $13.4 billion in 2022. 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 94,000 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
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