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    Utilization Review Coordinator - Nashville, United States - UHS

    UHS
    UHS Nashville, United States

    3 weeks ago

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    Description
    Responsibilities Hermitage Hall (a UHS company) is one of Middle Tennessee's largest stand-alone psychiatric residential treatment Hospitals.

    Licensed by Tennessee Department of Mental Health and Substance Abuse Services as a mental health residential treatment center for children and youth, Hermitage Hall has provided services to families for over 30 years.


    Website:
    are currently looking for a Utilization Review Coordinator to join our team of dedicated professionals. This role requires a full background check including fingerprint, drug screen, and employment verification.
    JOB SUMMARYThis position proactively monitors utilization of continuum services for residents at Hermitage Hall. He/She is responsible for concurrent, retro, and extended stay reviews as well as precertification of residents prior to admission. This position is responsible for submitting appeals and/or coordinating peer to peer reviews if continued authorization is denied. He/She actively communicates and coordinates with multiple departments regarding utilization needs. He/She facilitates and fosters positive relationships with insurance and other outside agencies. He/She works diligently to optimize reimbursement and authorized days for Hermitage Hall residents.


    ESSENTIAL JOB DUTIES AND RESPONSIBILITIES:
    Confirms resident's eligibility and benefits.

    Builds cases and provides clinical information to insurance companies Submits required documentation on residents to initiate payment upon admission and terminate payment on discharge Performs other duties as assigned by Director of Admissions and UR This opportunity provides the following:

    Challenging and rewarding work environment Growth and development opportunities within UHS and its subsidiaries Competitive Compensation Excellent Medical, Dental, Vision and Prescription Drug Plan 401k plan with company match Generous Paid Time Off Free meals About Universal Health Services One of the nation's largest and most respected providers of hospital and healthcare services, Universal Health Services, Inc.

    (UHS) has built an impressive record of achievement and performance. Growing steadily since its inception into an esteemed Fortune 500 corporation, annual revenues were $14.3 billion in 2023.

    During the year, UHS was again recognized as one of the World's Most Admired Companies by Fortune; and listed in Forbes ranking of America's Largest Public Companies.

    Headquartered in King of Prussia, PA, UHS has approximately 96,700 employees and continues to grow through its subsidiaries.

    Operating acute care hospitals, behavioral health facilities, outpatient facilities and ambulatory care access points, an insurance offering, a physician network and various relatedservices located all over the U.S.

    States, Washington, D.C., Puerto Rico and the United Kingdom.

    Qualifications EDUCATION Minimum of a Bachelor's Degree in the area of Counseling, Psychology, or Social Services related field or Nursing BSN or RN.

    Masters level preferred. EXPERIENCE Minimum of two years' experience working in mental health, preferably in a residential or acute care setting. Knowledge of managed care organizations.

    Demonstrates understanding of third party reimbursement and processes involved; works well in prioritizing review processes within a managed care environment uses ability to interpret admission and continued stay criteria to advocate for appropriate maintenance of benefits.

    Demonstrates clear and consistent understanding of admission and discharge functions and can discuss current psychopathology with reviewers utilizing integrated clinical knowledge relating to diagnosis to evidenced clinical documentation.

    Demonstrates the ability to provide meticulous record keeping and organizational skills. Must be at least 21 years of age.

    EEO Statement All UHS subsidiaries are committed to providing an environment of mutual respect where equal employment opportunities are available to all applicants and teammates.

    UHS subsidiaries are equal opportunity employers and as such, openly support and fully commit to recruitment, selection, placement, promotion and compensation of individuals without regard to race, color, religion, age, sex (including pregnancy, gender identity, and sexual orientation), genetic information, national origin, disability status, protected veteran status or any other characteristic protected by federal, state or local laws.

    We believe that diversity and inclusion among our teammates is critical to our success.

    Avoid and Report Recruitment Scams At UHS and all our subsidiaries, our Human Resources departments and recruiters are here to help prospective candidates by matching skill set and experience with the best possible career path at UHSand our subsidiaries.

    During the recruitment process, no recruiter or employee will request financial or personal information (e.g., Social Security Number, credit card or bank information, etc.) from you via email.

    Our recruiters will not email you from a public webmail client like Hotmail, Gmail, Yahoo Mail, etc.

    If you suspect a fraudulent job posting or job-related email mentioning UHS or its subsidiaries, we encourage you to report such concerns to appropriate law enforcement.

    We encourage you to refer to legitimate UHS and UHS subsidiar
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