Utilization Review Coordinator - PRN | Voyages Conroe

At Voyages Behavioral Health/ PAM Health, we care for chronically and critically ill patients who require extended hospital care. PAM Health has over 80 hospital locations and employs over 11,000 people across the country. Our teams work together to deliver the highest level of compassionate care ensuring the best possible outcome for our patients.

What can we offer you as a full-time employee?

• Medical benefits: EPO/HDHP/HSA options, including prescription coverage, Rx ’n Go, and Teladoc
• Comprehensive dental and vision benefits
• Employee Assistance Program, including counseling, legal, and financial services
• Flexible spending (FSA) and health savings (HSA) accounts
• Life and Disability insurance benefits
• Education/In-Service Opportunities including continuing education and tuition assistance
• Supplemental benefits: Accident, critical illness, cancer, pet, and identity theft protection insurance options
• Auto, Home, Cell Phone, and Gym Membership discount offerings
• Personal Travel Discounts
• 401(k) plans and discretionary employer match
• Generous Paid Benefit Time
  
  

Under the direction of the Director of Utilization Review, the responsibilities of the Utilization Review Coordinator are to manage the review of assigned admissions, continued stays, utilization practices and discharge planning according to the approved clinically valid criteria. The Utilization Review Coordinator will review clinical content of medical record, participate in treatment team meetings, collaborate with physicians, therapist, nurses and pertinent staff on gathering the necessary data to communicate with insurance companies/authorizing entities to ensure initial precertification and continued authorization is achieved. Utilization Review Coordinator will ensure reviews and analysis of pre-certifications and continued stay reviews, follow-up on unfinished pre-certifications from the day before and coordinate with the treatment team on any follow-ups necessary. The Utilization Review Coordinator will be trained in all aspects relative to timely gathering of clinical criteria, communication of clinical criteria, and entry of supporting clinical criteria into computer-based systems. This position will contribute to department meetings, quality initiatives and maintain services within TJC requirements.

• Education and Training: Masters or bachelor's degree in nursing, social work, mental health/behavioral sciences, or related field required. Licensed if applicable in the state in which the hospital resides. Current BLS certification required. Crisis management certification per hospital policy and standards required.
• Experience: One to three years of acute care behavioral health management provided to a wide range of demographics and ages preferred.