Utilization Reviewer Coordinator
US-FL-Fort Lauderdale
external
Req #: 168220
Type: Full-Time
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Overview: The Utilization Review Coordinator will perform admission and continued-stay reviews. This position also assists with performing discharge planning to patients. Responsibilities: * Review precertification requests for medical necessity and collaborate with medical providers for additional clinical information as needed. * Establish rapport with colleagues, support staff, patients, families, and physicians, demonstrating strong teamwork and relationship management skills. * Utilize coordination of services, patient advocacy, and resource management to enhance service quality, promote cost-effective outcomes, and prevent unnecessary re-hospitalization. * Provide counsel and in-service training on utilization management practices as applicable. * Identify alternative resources, address issues with referrals and providers promptly, and demonstrate effective decision-making in case management. Qualifications: Education * Associate degree or equivalent experience in a health care related field. * Bachelor's degree preferred. * Knowledge of behavioral health systems and Utilization Management required. Experience * Minimum two (2) years of professional experience in a health care setting, preferably inpatient preferred. * Minimum one (1) year clinical or utilization review or case management preferred. * Knowledge of managed care regulations required. Licenses/Certifications * LPC, LMSW or RN or other healthcare related licensure preferred
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