Utilization Review Coordinator - CST/EST

This is where you change your story…

At Meadows we understand that new directions to career advancing, and improvement can be scary, but we are excited to offer you a possible new rewarding chapter with us! Come join us in transforming lives!

Who are we?

Meadows Behavioral Healthcare is a leader in the behavioral health industry. Meadows Behavioral Healthcare offer a range of specialized programs including residential, outpatient and virtual treatment. We provide care for drug and alcohol addiction, trauma, sexual addiction, behavioral health conditions, and co-occurring disorders. We offer state-of-the-art care including neurofeedback and other services. Our evidence-based approach is rooted in decades of clinical experience, with more than 45 years in the field. Our approach is different and success stories from our patients are the proof.

Who are you?

Are you compassionate, innovative and have a passion to make an impact? Are you looking to get your foot in the door with a company that will believe in your abilities and train you to advance? 80% of our current top-level executive staff are organic internal promotions from within.

We might be a perfect fit for you!

Position Summary

As the Utilization Review Coordinator, you will develop and implement systems for authorizations for Inpatient, RTC, PHP and IOP Services. You will conduct pre-certs, concurrent and extended reviews. You will ensure quality documentation of patient care.

Responsibilities

• Utilization Review:
  • Provide professional and thorough communication with external representatives to obtain authorization for admission and continued stay.
  • Monitor each step of the authorization process to proactively identify potential problems and optimize outcome.
  • Minimize the number of cases that need to be referred for psychiatric peer/peer review.
  • Interact with patient care staff to assure patient assessment and treatment plan is accurately and consistently reflected in facility documentation.
  • Prioritize multiple and various types of case activity, coordinate with UM team to ensure all deadlines are met with highest possible quality of delivery.
  • Maintain cumulative documentation regarding action taken during the UR process.
  • Conduct reviews to ensure that services and documentation conform to the facility protocols, and the requirements of third-party payer sources.
• Clinical Team Member
  • Interact with patient care staff as noted above.
  • Attend treatment staffing and other scheduled meetings to obtain and present information on patient status, care and stay.
  • Communicate authorization status, issues or problems to appropriate staff/departments.
• Payer Management
  • Obtain and maintain authorization for each patient. Problem-solve issues relating to stay or service.
  • Respond quickly and effectively to requires for information.
  • Nurture positive and professional relationships with external (third-party payers) sources.