Utilization Review Coordinator conducts utilization reviews to determine if patients are receiving care appropriate to illness or condition. Monitors patient charts and records to evaluate care concurrent with the patients treatment. Being a Utilization Review Coordinator reviews treatment plans and status of approvals from insurers. Collects and complies data as required and according to applicable policies and regulations. Additionally, Utilization Review Coordinator consults with physicians as needed. May require a bachelor's degree. Typically reports to a supervisor. Typically requires Registered Nurse(RN). The Utilization Review Coordinator contributes to moderately complex aspects of a project. Work is generally independent and collaborative in nature. To be a Utilization Review Coordinator typically requires 4 to 7 years of related experience. (Copyright 2024 Salary.com)
We are looking for a Utilization Review Coordinator to join our team! This position facilitates all aspects of the utilization review process for clients in a trauma informed care setting that promotes a strong team environment of support.
Job Responsibilities include, but are not limited to:
-Handling all aspects of utilization review.
-Calling in initial authorizations, single case agreements, and concurrent reviews.
-Reviewing charts with clinical team to determine level of care, and reviewing documentation to ensure it accurately describes level of care and ongoing need for treatment.
-Demonstrating knowledge and application of ASAM criteria and NJSAMS.
-Working with the Clinical Director and team.
Qualifications
-Knowledge in addiction and co-occurring disorders
-Knowledge of insurance companies and clinical assessment skills
-Organized and flexible, with at least 1 year of working in mental health/addictions/ co-occurring treatment environment
Please submit your resume and salary requirements if you are interested in joining our team.
Job Types: Full-time, Part-time
Benefits:
Schedule:
Education:
Experience:
Ability to Relocate:
Work Location: In person
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