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Utilization Review Coordinator

North Spring Behavioral Healthcare
Full-time
On-site
Leesburg, Virginia, United States
Position Overview
North Spring Behavioral Healthcare is looking for a full-time Utilization Review Coordinator to join our compassionate and dynamic team.

What We Offer

Competitive Salary

Comprehensive Benefits Package

Health insurance – Available after 30 days.

Paid Time Off – Start earning after 90 days.

401(k) with company match – Eligible after 30 days.

Key Responsibilities

Perform clinical reviews over the telephone to evaluate the appropriateness of admission, continued stay, and discharge criteria.

Facilitate discharge planning with the treatment team and coordinate continuum of care for the patient with Social Worker.

Attend treatment team meetings and serve as a liaison and patient advocate between insurance companies and the treatment team.

Notify and alert the Director of Outpatient Services of potential utilization review problems or denials; assist in the preparation and implementation of the appeals process.

Monitor documentation in clinical records and report problematic areas to the appropriate supervisor and Director of Outpatient Services.

Assist admissions with screening patients on the pre-hospital level to ensure admission criteria are met.

Qualifications

Good verbal and written skills, ability to rotate shifts and programs as necessary, and maintain confidentiality of patient information.

Education: Master’s Degree in Human Services or Registered Nurse License required.

Experience: Prior experience in a healthcare setting with strong knowledge of insurance billing and regulations; preference for experience with children and adolescents in psychiatric settings.

Physical Requirements: Ability to lift and carry up to 50 pounds; spend 80-90% of the time standing, walking, kneeling, reaching; able to perform CPR and First Aid.

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 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.

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