Utilization Review Coordinator-Behavioral Health
UHS
Summary
Lighthouse Behavioral Health Hospital, located near beautiful Myrtle Beach, SC, treats adolescents, adults and senior adults in need of psychiatric services, as well as adults who suffer from a chemical dependency, dual diagnosis, or are in need of rehabilitation. Lighthouse offers 24-hour admissions, needs assessment, and referral services.
Job description
Position Summary
The UR Coordinator is responsible for conducting utilization and quality management activities in accordance with Utilization Review policies and procedures. The Coordinator performs the overall function of providing an ongoing, systematic process for the measurement and assessment of the necessity, appropriateness, and efficiency of facility healthcare services and procedures.
- Assisting in the promotion and maintenance of high quality care through the analysis, review, and evaluation of clinical criteria as it relates to patient treatment and length of stay.
- Reviewing cases for appropriateness of admission, continued stay, and discharge planning.
- Managing and effectively utilizing insurance benefits through timely prospective, concurrent, and retrospective review activities.
- Complies with all Administrative, Clinical, and HR policies and procedures.
- Maintains an awareness of patient funding sources, discharge planning needs, and available resources in order to facilitate continuity of care.
- Plans and organizes the functions of the facilities Case Management system to minimize denials of payment.
- Performs prospective, concurrent and retrospective telephonic reviews for inpatient Mental Health and Dual Diagnosis services.
- Promotes alternative care programs and researches available options including costs and appropriateness of patient placement in collaboration with discharge planners and patients.
Requirements
- Registered Nurses, Preferred
- With licensure to practice in SC
- One to three years of experience in utilization review, case management, or discharge planning preferred
- Three years of experience in a Behavioral Health facility providing multiple levels of care preferred
- Prior experience in Medical Records a Plus
Benefits
- Medical, Dental & Vision
- Prescription Drug Plans
- 401(k) Matching
- Discounted Stock Plan
- SoFi Student Loan Refinancing
- Paid Time Off
- Career Development Opportunities
Company overview
Universal Health Services, Inc. (UHS) is one of the nation's largest and most respected providers of hospital and healthcare services, operating as a Fortune 300 corporation headquartered in King of Prussia, Pennsylvania. Founded in 1979, UHS has grown into a major healthcare enterprise with approximately 99,000 employees and annual revenues exceeding $14 billion. The company operates through its subsidiaries, managing 29 acute care hospitals, 331 behavioral health facilities, and 60 outpatient and other facilities across 39 U.S. states, Washington D.C., Puerto Rico, and the United Kingdom. UHS provides comprehensive healthcare services including acute care, behavioral health treatment, cancer centers, and ambulatory surgical centers. The company's strategy focuses on building or acquiring high-quality hospitals in rapidly growing markets and investing in advanced medical equipment and skilled personnel to become the leading healthcare provider in each community it serves. UHS is publicly traded on the New York Stock Exchange (NYSE: UHS) and has established a strong reputation for delivering compassionate, high-quality care while maintaining financial stability and operational excellence.