Utilization Review Coordinator NBH

Utilization Review Coordinator NBH

Wellpath | West Palm Beach, FL, 33417, US
Salary Range:$66,000 – $77,000 Salary range estimated by Zippia

Posted 14 days ago

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Description

**Why Wellpath**

Here at NeuroBehavioral Hospitals, everything that we do is about taking care of people - our patients, our staff and our partners. We are committed to making a difference by providing hope and healing to vulnerable patients in challenging clinical environments. Our talented, compassionate team thrives in an autonomous environment, is empowered and supported by education, training and the resources to practice healthcare the way it is meant to be and strives to "Always Do The Right Thing!"

**About this role**

The Utilization Review Coordinator NBH will perform admission and continued-stay reviews. This position also assists with performing discharge planning to patients.

**What you bring to the table**

**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

**What you will do**

**KEY JOB RESPONSIBILITIES:**

+ Review precertification requests for medical necessity and works with the medical provider for those request that require additional clinical information.

+ Establish effective rapport with other employees, professional support service staff, customers, clients, patients, families, and physicians and exhibit strong team player abilities

+ Use effective relationship management, coordination of services, resource management, education, patient advocacy, and related interventions to contribute to the promotion of improved quality of services, promote cost effective clinical outcomes, prevent re-hospitalization or more acute level of care, when possible and appropriate, and work collaboratively other departments to ensure proper continuity of care.

+ Provide advice, counsel, and in-service on utilization management, as applicable.

+ Identify appropriate alternative resources and demonstrate prudent decision-making and problem-solving abilities in managing each individual case.

+ Identifies patients receiving the level of care requiring further justification for reimbursement purposes, through the review of the medical record and based on set reimbursement criteria protocols

+ Identifies issues with referrals and providers in a timely manner and coordinates the issue resolutions.

NeuroBehavioral Hospitals(Wellpath) is an EOE/Minorities/Females/Vet/Disability Employer

**Our investment in you**

+ Medical, Dental and Vision Insurance plan options

+ Time off & leave benefits

+ 401K

+ Tuition Reimbursement

+ Parental benefits

+ Perks and discounts

+ And more available herehttps://wellpathcareers.com/ (https://wellpathcareers.com/#rewards)

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**Job** _22-131626_

**Facility** _NeuroBehavioral Hospitals of the Palm Beaches-North_

**Type** _Part-Time_

**Shift** _Day 8 hour_

**Recruiter** _Erika Jones_

**Recruiter : Email** _erikjones@wellpath.us_