Aurora Behavioral Health System has an exciting position available in the Utilization Management department! The Utilization Coordinator/Specialist will monitor adherence to the hospital's utilization review plan to ensure the effective and efficient use of hospital services in order to optimize reimbursement for the hospital. The Coordinator will monitor the appropriateness of hospital admissions and extended hospital stays. The Coordinator will improve patient outcomes and close gaps in care by providing post discharge follow up with patients.
- Clinical degree such as nursing, social work, psychology, health information management or other related healthcare field.
- Experience in a psychiatric setting and knowledge of health care service delivery systems and third party reimbursement.
- Excellent verbal and written communication skills.
- Knowledge of managed care environment; ability to apply and interpret admission and continued stay criteria.
- Understanding of admission and discharge function; familiarity with medical terminology, diagnostic terms and treatment modalities.
- Knowledge of medical record keeping; strong interpersonal, organizational, evaluative, and time management skills.
- Policy interpretation skills; familiarity with applicable standards and regulations; flexibility; attention to detail; able to comprehend psychiatric evaluations, consults, lab results, etc.r
- Responsiveness to deadlines; assertiveness, persistence, and persuasiveness; able to work with minimal direction or supervision.