Utilization Review Coordinator
Location: Denver Colorado
Description: Eating Recovery Center is at present recruited Utilization Review Coordinator right now, this vacancy will be placed in Colorado. Further informations about this vacancy opportunity kindly read the description below. SUMMARY
The UR Coordinator serves as a liaison to managed care organizations, provides clinical information to obtain authorizations, optimizes reimbursement, and monitors! the delivery of quality treatment to patients and their families at the appropriate level of care.
ESSENTIAL DUTIES AND RESPONSIBILITIES include the following. Other duties may be assigned.
Conducts concurrent reviews with managed care organizations in a timely manner as requested.
Is pro-active and independent in gathering information for reviews from the patient record.
Takes the initiative to seek information from members of the treatment team.
Implements an effective tracking system to track upcoming reviews.
Conducts the reviews at the appropriate day or at a specified time if applicable.
Presents data in an articulate manner.
Submits any written materials requested by managed care organizations in a timely manner.
Maintains persistence and focus through difficult and/or complicated review processes.
Facilitates physician to physician reviews with managed care organization medical staff as requested.
Establishes and mai! ntains positive and supportive working relationships with mana! gement team, physicians, all internal departments, and managed care organizations.
Completes data entry and documentation as necessary for each review.
Compares inpatient medical records to established criteria and confers with medical and nursing personnel and other professional staff to determine legitimacy of treatment and length of stay.
Attends regular treatment team meetings in order to share information and interact with the team.
Communicates relevant information in a timely manner to both business and clinical staff.
Maintains calm demeanor, has ability to mitigate potential conflicts and examine situations from multiple points of view.
Abstracts data from records and maintains statistics.
Prepares and submits appeals to managed care organizations.
EDUCATION and/or EXPERIENCE
Licensed Masters Level Professional such as LCSW, LMFT, or LPC or RN- Bachelors in Nursing.
3-5 years experience in Behavioral Health required. Ide! al candidate would have experience in eating disorder field.
Knowledge of medical necessity criteria for different levels of care.
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If you were eligible to this vacancy, please email us your resume, with salary requirements and a resume to Eating Recovery Center.
If you interested on this vacancy just click on the Apply button, you will be redirected to the official website
This vacancy starts available on: Thu, 07 Nov 2013 10:39:07 GMT