Responsibilities Utilization Management Coordinator - PRN Opportunity
West Oaks Hospital has provided psychiatric care to the Houston area and surrounding communities for over four decades. Our 176-bed acute care facility includes a 16-bed residential treatment center for adult chemical dependency. We offer a broad range of behavioral health programs for children, adolescents and adults at multiple levels of care including inpatient, partial hospitalization and intensive outpatient. The hospital is accessible 24/7 to assist with treatment options and insurance coverage.
West Oaks Hospital is seeking a dynamic Utilization Management Coordinator to join our team. The role provides administrative case management, conducts admission and continued stay reviews, assists in appealing inappropriate reimbursement denials, and participates in the hospital’s Performance Improvement Plan.
Job Duties/Responsibilities:
Monitors cases for medical necessity, appropriate duration of service and over or under utilization of resources.
Completes admission and continued stay reviews with managed care companies and obtains certification.
Identifies documentation defects.
Participates in efforts to recover denials.
Collaborates with medical staff, administration and treatment team.
Benefits:
Challenging and rewarding work environment
Competitive Compensation
Career development opportunities within UHS and its 300+ Subsidiaries
Qualifications Requirements:
Education: Bachelor’s Degree in Psychology, Social Work, Nursing or related field, or Associate Degree in Nursing. Preferred: Master’s degree in a related field.
Licensure and certification: CPR and hospital de-escalation certifications. Preferred: TX LVN, RN or LCDC license.
Experience: Minimum of one year of case management experience and one year inpatient psychiatric experience. Preferred: 5 years of clinical or case management experience.
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About Universal Health Services Universal Health Services, Inc. (UHS) is one of the nation’s largest providers of hospital and healthcare services. In 2024, annual revenues were $15.8 billion. UHS is headquartered in King of Prussia, PA, and employs approximately 99,000 people across its subsidiaries, including acute care hospitals, behavioral health facilities, outpatient facilities and related services across the U.S., D.C., Puerto Rico and the United Kingdom.