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Utilization Review Nurse
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Utilization Review Coordinator

Neuropsychiatric Hospitals -
Huber Heights, OH

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Job Details

Full-time

Benefits

Health insurance
Dental insurance
Paid time off
Employee assistance program
Vision insurance
Employee discount

Qualifications

Customer communication
Employee relationship building
Transitional care planning in clinical case management
Bachelor's degree
Clinical data entry
Utilization management
Resource utilization in healthcare
Managing patients as a clinical case manager
Hospital experience
Quality data entry

Full Job Description

About Us:

Healing Body and Mind.

NeuroPsychiatric Hospitals is a national leader in behavioral healthcare, specializing in patients with acute psychiatric and complex medical needs. Our hospitals use an interdisciplinary, multi-specialty approach that delivers high-quality, patient-centered care when it’s needed most.

With locations in Indiana, Michigan, Texas, and Arizona, we’re expanding access to our unique model of care across the United States. Join us and be part of a team dedicated to making a lasting difference in the lives of patients and families every day

Overview:

North Valley Behavioral Hospital, a brand new psychiatric hospital within the NeuroPsychiatric Hospitals network, is looking for a Utilization Review Coordinator to coordinate patients’ services across the continuum of care by promoting effective utilization, monitoring health resources and elaborating with multidisciplinary teams.

Benefits of joining NPH

Competitive pay rates
Medical, Dental, and Vision Insurance
NPH 401(k) plan with up to 4% Company match
Employee Assistance Program (EAP) Programs
Generous PTO and Time Off Policy
Special tuition offers through Capella University
Work/life balance with great professional growth opportunities
Employee Discounts through LifeMart

Responsibilities:

Filing documents as needed.
Initial Precertification with payors.
Concurrent Clinical review with payors.
Document in the electronic system daily in real time.
Admission audit.
Ensures that CON’s/RON’s and CMS certifications are completed by provider.
Consistently demonstrates professionalism with all internal and external customers as evidenced by positive customer and peer Communicates effectively with all staff and patients as evidenced by the establishment and maintenance of productive working relationships.
Maintains knowledge of current trends and developments in the field by reading appropriate books; journals and other literature and attending related seminars or conferences.
Maintains a professional approach with Assures protection and privacy of health information as attained through written, electronic or oral disclosures.
Cooperates and maintains good rapport with nursing staff, medical staff, and other departments.
Seeks guidance and remains knowledgeable of, and complies with, all applicable federal and state laws, as well as hospital polices that apply.
Complies with hospital expectations regarding ethical behavior and standards of conduct.
Complies with federal and hospital requirements in the areas of protected health information and patient information.
Reconsiderations, assists with appeals as needed, arrange peer to peer level reviews, and report the outcomes to the VP of Care Management and Team.
Provides education to nursing staff. leadership team, and providers regarding documentation.
Actively works with the business office regarding resolution of appeals/denials and retrospective reviews.

Qualifications:

Education: Bachelor's in Behavioral Health, Social Work, Counseling, Nursing or Psychology required. Master's degree preferred.

Experience: Minimum of 2 years of utilization review experience in a hospital setting required. Minimum of 2 years of case management experience, including discharge planning in a hospital setting required.

Licensure: Certified Case Manager (CCM) or Accredited Case Manager (ACM) preferred. Basic Life Support (BLS) and Handle with Care (HWC) obtained during orientation, if applicable.

Skills: Must have strong knowledge of medications and demonstrate exceptional time management, data entry, and communication skills. Must be detail oriented.#INDEEDLOW

Apply Now

Refine Your Search

utilization manager jobs

Utilization Review Coordinator

Senior Manager, Utilization Management

Manager Anesthesia Support Services

Utilization Manager

Utilization Manager

Utilization Management Physician Reviewer (Weekends)

Manager, Utilization Review

Utilization Review Specialist

Pharmacy Operations Manager (Remote)

Clinical Manager, Global

Care Manager, Concurrent Review (Remote)

Regulatory Process Manager (IDRE)

Clinic Engagement Manager

Virtual Reimbursement Manager

Program Manager EHR Trainer

Utilization Management Manager Full Time

Utilization Review Specialist

Remote Nurse Case Manager - Utilization Review SNF

Stakeholder Engagement Manager (IDRE)

Utilization Review Nurse

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