Behavioral Health Intake and Utilization Review Coordinator

Behavioral Health Intake And Utilization Review Coordinator

Summary: The Behavioral Health Intake and Utilization Review Coordinator is responsible for bed management, reviewing intake assessments, verifying clinical appropriateness for services, coordinating admissions, and overseeing utilization review activities to ensure timely access to care and appropriate resource utilization. This role is actively involved with communicating with other community hospitals and Emergency Departments and will also facilitate outside admissions to our services to maximize hospital census. This role ensures adherence to regulatory and payer requirements while serving as a key liaison between patients, providers, and insurance carriers.

Education: Bachelor's degree Nursing required. Master's degree preferred.

Experience: Minimum 23 years of experience in behavioral health, preferably in intake or utilization review roles.

License: RI RN License required.

Skills and Qualifications:

• Strong clinical assessment and diagnostic skills.
• Working knowledge of behavioral health levels of care and medical necessity criteria (e.g., MCG, InterQual).
• Familiarity with insurance authorization processes and managed care systems.
• Excellent organizational, communication, and interpersonal skills.
• Proficiency in EHR and Microsoft Office Suite.

Working Conditions, Physical Environment and/or Safety Requirements: Lifting up to 30 lbs. and occasionally lifting and/or carrying such articles as files, books, etc. Involves sitting, walking, stooping, and reaching. However, as necessary, must be able to meet the physical requirements for staff level positions in the department(s).