Utilization Review Coordinator

Employer
UHS - North Springs Behavioral center
Location
Leesburg, VA
Posted
Sep 15, 2017
Closes
Sep 18, 2017
Function
Accountant, IT
Industry
Healthcare
Hours
Full Time
North Spring Behavioral Healthcare, a subsidiary of Universal Health Services, Inc. (UHS), is a Department of Behavioral Health and Developmental Services (DBHDS)-licensed, and Joint Commission approved 87-bed Psychiatric Residential Treatment Facility, a 15-bed Inpatient Acute Psychiatric Hospital and newly opened Partial Hospital Program that provides outpatient services.North Spring is situated on 42 acres of scenic greenlands in historic Leesburg, VA, approximately 25 miles northwest of Washington, DC We provide therapeutic programs for adolescents in a safe and secure environment that encourages growth and self-responsibility. Universal Health Services, Inc. (UHS) is one of the nation's largest and most respected healthcare management companies, operating through its subsidiaries acute care hospitals, behavioral health facilities and ambulatory centers nationwide. Founded in 1978, UHS subsidiaries now have more than 85,000 employees. The UHS business strategy is to build or purchase healthcare properties in rapidly growing markets and create a strong franchise based on exceptional service and effective cost control. Our success comes from a responsive management style and a service philosophy based on integrity, competence and compassion. With new services being added we are seeking a Utilization Review Coordinator. The UR Coordinator assists admissions in screening patients at the pre-hospital level to ensure that admission criteria are met, and when admitted, follows the chart checking that documentation reflects and meets admission, continued stay, and discharge criteria. Interacts and communicates with clinical staff, Business Office, Admissions, Medical Records, third party reviewers and hospital administration to help receive hospital care they need. Key Responsibilities: &nbs p; 1. Performs clinical reviews over the telephone. Reviews that entire chart to evaluate the appropriateness of admission, continued stay, discharge criteria and identifies high-risk cases.. 2. Facilitates discharge planning with treatment team and coordinates continuum of care for the patient with Social Worker. Monitors the effectiveness of patient outcomes. 3. Attends treatment team meetings and serves as a liaison and patient advocate between insurance companies and the treatment team. 4. Notifies and alerts Director of UR of potential utilization review problems or denials; assists in the preparation and implementation of the appeals process. 5. Monitors documentation in clinical records and reports problematic areas to appropriate supervisor, Director of UR. 6. Assists admissions with screening patients on the pre-hospitalization level to ensure admission criteria are met. Minimum Requirements: Master's degree in Human Services or related field. Prefer experience with children and adolescents in psychiatric facility or rehabilitation program. Strong preference for candidates with UR experience. Subject to criminal background check and pre-employment drug screen. Must be 21 years of age.