Overview Rutgers University Behavioral Health Care (UBHC), established in 1971, offers a full continuum of evidence-based behavioral health and addiction services for children, adolescents, adults, and seniors throughout New Jersey. UBHC's 1,060 experienced behavioral health professionals and support staff are dedicated to treatment, prevention, and education. UBHC, one of the largest providers of behavioral health care in the country, has a budget of $260 million and has 15 sites throughout New Jersey. Services are readily accessible and include: inpatient, outpatient, partial hospitalization, screening, crisis stabilization, family/caregiver support, community outreach and case management, supportive housing, supported employment, prevention and consultation, employee assistance programs, and a licensed therapeutic school from preschool through high school.
Specialty services include the New Jersey suicide prevention helpline and peer help lines for police, veterans, active military, teachers, mothers of special needs children and child protective service workers. In FY2016, UBHC treated 16,199 consumers, had 24,502 admissions, and touched the lives of 19,441 individual callers through peer support. In addition, UBHC is the primary mental health training resource for the New Jersey departments of Human Services, Children and Families, and Corrections, delivering 16,000 trainings each year.
Job Summary Rutgers The State University is seeking a Utilization Management Coordinator (UM) within Rutgers University Behavioral Healthcare. Under the direction of the Utilization Review (UR) Supervisor, the Utilization Management (UM) Coordinator conducts utilization reviews to ensure that clinical services meet medical necessity and all applicable standards for regulatory funding and accrediting agencies.
Among the key duties of this position are the following:
Reviews admissions, continued stays and discharges to determine if they are consistent with established criteria. Refers to the UR Supervisor, those that require additional expertise. If criteria are not met, notifies the UR Supervisor.
Conducts certification, pre-certification and continuing certification requirements for Medicaid, Medicare and insurance clients.
Effectively communicates outcomes of precertification and concurrent reviews to appropriate members of the treatment team, leadership and UR Supervisor.
Communicates routinely with UR Supervisor regarding specific reimbursement issues.
Serves as resource for treatment team related to medical necessity interventions and documentation.
Qualifications Minimum Education and Experience: Registered nurse with a license to practice in the State of New Jersey or a Bachelor's Degree in the Mental Health field.
Must have at least three (3) years of mental health experience.
Certifications/Licenses: Registered Nurse. Applicants possessing a degree in Social Work must have an active New Jersey certification/licensure as required by the State Board of Social Work.
Benefits Rutgers offers a comprehensive benefits package to eligible employees, based on position, which includes:
Medical, prescription drug, and dental coverage
Paid vacation, holidays, and various leave programs
Competitive retirement benefits, including defined contribution plans and voluntary tax-deferred savings options
Employee and dependent educational benefits
Life insurance coverage
Employee discounts programs
Affirmative Action/Equal Employment Opportunity Statement It is university policy to provide equal employment opportunity to all its employees and applicants for employment regardless of their race, creed, color, national origin, age, ancestry, nationality, marital or domestic partnership or civil union status, sex, pregnancy, gender identity or expression, disability status, liability for military service, protected veteran status, affectional or sexual orientation, atypical cellular or blood trait, genetic information (including the refusal to submit to genetic testing), or any other category protected by law.