Utilization Review Coordinator

OUR CULTURE:

The minute you start working here, you become an integral part of our WE CARE Culture.

Our mission is to provide a transformational influence for patients and their loved ones. Anchored in evidence-based practices, we facilitate person-centered accessible care.

We provide best-in-class treatment for patients with a diagnosis of substance use disorder, mental health disorder or both. Our core values are represented in the acronym “WE CARE.”

Wellness - In the WE CARE culture, we embody WELLNESS through demonstrating empathy compassion, and connection.

Excellence - We demonstrate EXCELLENCE with best-in-class, safety-focused clinical and medical treatment, strong leadership, and a passion for patient care.

Commitment - Our COMMITMENT to recovery and the community is shown through philanthropy, loyalty and unity. We believe that true recovery is an effort that requires the dedication level of "all in, all the time".

Accountability - We encourage ACCOUNTABILITY in all day-to-day activities, and honor that accountability through holding people accountable to the truth; with an understanding that truth without love is cruelty. Tell the truth with love.

Respect - As a patient, you will always be treated with RESPECT here. Our conversations and actions are hallmarked by honesty, integrity, trust, and humility.

Empower - We strive to EMPOWER all staff and patients to succeed, and White Light Behavioral Health is a place where all are welcome and encouraged to thrive and develop in an inclusive, diverse, and equitable environment

**Overview: **

We are seeking a detail-oriented Utilization Review Coordinator to join our team.

The Utilization Review Coordinator is responsible for retrospective and concurrent Utilization Review activities. They are a member of the Multidisciplinary Team and monitors the documentation accuracy and clinical compliance. They are also responsible for organizing, directing, and coordinating all Utilization Review activities in accordance with standards of State and Federal regulations

**Duties:**

• Knowledge and understanding of standards or practice.
• Knowledge and understanding of Utilization Review and Performance Improvement principles and standards.
• Knowledge and understanding of psychiatric diagnoses, treatments, and clinical documentation.
• Knowledge and understanding of Accreditation Guidelines, regarding treatment centers.
• Knowledge of data collection and statistical analysis.
• Adheres and refers to Policy and Procedure Manual and other resource materials, as needed, for direction.
• Works closely with center staff, providing feedback, as necessary, regarding findings or reviews.
• Provides in-service and educational training for staff regarding documentation and Performance Improvement.
• Participates in Treatment Team meetings, as necessary, to assist in formulating clinically appropriate Treatment Plans/Reviews.
• Performs random clinical reviews on patient records, reports findings to Clinical Program Director or Executive Director

(etc.)

**Experience: **

• Knowledge of addiction and 12 steps
• Knowledge of levels of care
• Knowledge of top 5 payors
• Knowledge of ASAM criteria
• Must be able to work in a fast-paced environment
• Must be self-motivated
• A minimum of 3 years clinical experience, preferably in Utilization Review. Experience in an acute psychiatric facility or partial hospitalization setting preferred

Joining our team as a Utilization Review Coordinator offers the opportunity to contribute to quality patient care while advancing your career in healthcare.