UR COORDINATOR - PRN

Rockford Center is a 138-bed mental health facility located in Newark, DE, providing easy access to a full complement of inpatient and partial behavioral health programs for children and adolescents, adults, and older adults. Rockford is the only child inpatient behavioral health facility in DE, offers an experienced and tenured senior management team, and serves New Castle County and northern Maryland.

Website: Psychiatric and Substance Abuse Services | Rockford Center | Newark, DE

Position Summary:

The PRN Utilization Management (UM) Coordinator plays a critical role in ensuring appropriate and cost-effective care for patients within a behavioral health setting. This position is responsible for conducting utilization reviews, verifying medical necessity, and coordinating with clinical teams and insurance providers to support timely authorization of services. The UM Coordinator works on an as-needed basis, providing coverage during peak times, staff absences, or special projects.

Responsibilites:

• Completes pre-certs and concurrent reviews as assigned, on appropriate day and by the specified time.
• Completes write-ups on new admissions and step-downs/step-ups as assigned, along with the “Change Level of Care” form when applicable.
• Communicates with ARC to gather pre-cert information for new admissions as needed.
• Enters authorizations into the MIDAS by the end of each business day.
• Participates in daily treatment teams: communicates pertinent payor
  information, requests, or concerns; gathers information needed for reviews, and facilitates the signing of Medicare forms when applicable.
• Takes initiative to independently gather additional information for reviews as needed.
• Calls in discharge information to payor by the end of the business day following discharge, or on day of discharge as required by some payors.
• Signs patient treatment plans.
• Communicates to the Director of UR any unplanned or cancelled discharges, denied days, reasons given for underutilized days, and/or any payor-related problems.
• Facilitates physician reviews promptly when a case is denied.
• Maintains and updates appropriate records of the UR Department, including UR Worksheets and treatment team notes.

Benefits:

• • Competitive Compensation 
  • Chamberlain University Partnership discount
  • In-house Psychiatric Nurse Residency Transition-to-Practice
  • Orientation (Could earn 20 CEUs)
  • Career development opportunities across UHS and its 300 locations!
  • Diverse programming to expand your experience and energize your career
  • HealthStream online learning catalogue with plenty of free CEU courses

About Universal Health Services

One of the nation’s largest and most respected providers of hospital and healthcare services, Universal Health Services, Inc. (NYSE: UHS) has built an impressive record of achievement and performance, growing since its inception into a Fortune 500 corporation. Headquartered in King of Prussia, PA, UHS has 99,000 employees. Through its subsidiaries, UHS operates 28 acute care hospitals, 331 behavioral health facilities, 60 outpatient and other facilities in 39 U.S. States, Washington, D.C., Puerto Rico and the United Kingdom.

Requirements:

• Master’s prepared Social Worker or Licensed Registered Nurse (or eligible to receive or renew).
• Previous experience in Behavioral Health preferred, but not required.
• Current CPR
• Strong communication, organizational, and critical thinking skills.
• Ability to work independently and adapt to changing priorities in a fast-paced environment.

EEO Statement

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