Utilization Management Coordinator - Chicago, United States - Hartgrove Behavioral Health System

Hartgrove Behavioral Health System

Verified Company

Chicago, United States

1 week ago

Posted by:

Mark Lane

beBee recruiter

Description

Hartgrove Behavioral Health System consists of a 160-bed leading psychiatric hospital dedicated to providing quality behavioral health services for a diverse population of all ages.

A flagship behavioral health facility within Universal Health Services, Inc.

and throughout Illinois, Hartgrove is a state-of-the-art facility offering some of the most advanced technologies and programs found in the behavioral health field.

We are seeking a skilled
Utilization Management Coordinator for Admissions.

Duties:

Performs timely, daily precertifications, to secure initial authorization based on payer's criteria and in accordance with the hospital wide Utilization Management Plan.
Coordinates with the Business Office, Admissions Department and Utilization Management Department.
Obtains billing and insurance information, verification of benefits, communicates problematic benefit verification with Business Office, etc.
Update patient accounts to ensure accurate demographic information.
Advocates on behalf of the patient to ensure the appropriate level of care, including appropriateness of the admission.
Knowledgeable and able to explain Hospital programs, services, and treatment goals. Understands and considers basic growth and development needs specific to the age and population served.
Provides accurate and complete information to payers regarding reason for admissions.
Assures compliance with all applicable laws, codes, rules, and regulations that pertain to psychiatric admissions.
Trains other staff in the precertification process, policies, and procedures.
Obtains, organizes, and has current information regarding initial authorizations, pending authorizations, and initial denied authorization.
Maintains all data/records regarding the precertification process.
Participates in the hospitalwide Quality Assurance Program.

Skills:

Education:

Bachelor's degree in behavioral health field required; Master Degree preferred.

Experience:
1 year experience in Utilization Management; 1 year experience in mental health/psychiatry preferred

Knowledge:
Working knowledge of Illinois Confidentiality Act, ILPA process and detailed understanding of psychiatric criteria for various levels of care. Possesses knowledge of utilization management, insurance and managed care procedures. Current knowledge of regulating /accrediting agency guidelines. Basic knowledge of computer skills and statistical analysis desired.

Knowledgeable in behavioral health managed care and clinical assessment skills to align patient acuity with level of care practice guidelines - Diagnostic and Statistical Manual of Mental Disorders (DSM-V).

Effective oral and written communication skills to support patient advocacy/negotiating skills to ensure quality reviews with payers.

This is a full-time position with competitive compensation. We offer a comprehensive benefits package, including health insurance, retirement plans, paid time off, and professional development opportunities. If you are a highly motivated individual with a passion for healthcare, we encourage you to apply.

Pay:
From $51,000.00 per year

Benefits: