UR COORDINATOR

UHS•Reno, NV

9d•$26 - $50

About The Position

Willow Springs Center is looking for an experienced Utilization Review Coordinator to join our WSC team! Located in the heart of the Sierras, Reno, Nevada provides a destination location where employees can live, work and play. The location itself is a benefit; not to mention Nevada has no state income tax. Working at Willow Springs Center means building a career that is dynamic and satisfying; having the opportunity to work and learn from some of Nevada’s leading mental health professionals; and being a part of something meaningful that changes the world, one child at a time. Work at Willow Springs Center is a life path. At Willow Springs Center, we seek high performing, compassionate professionals dedicate to impacting the lives of youth ages 6 to 17 years of age. If you desire to make a difference through the work that you do, Willow Springs Center is the place for you. The UR Coordinator is responsible for collecting and compiling the clinical documentation necessary to provide evidence for the necessity of a course of treatment and present that documentation to referral sources and payor representatives.

Requirements

Knowledge of regulatory requirements for compliance, regulatory accreditation standards, patient rights standards, all federal and state laws/regulations and CDC guidelines.
Knowledge of computer and various software programs.
Knowledge of documentation requirements and procedures applicable to the Facility.
Knowledge of supervisory principles, practices and procedures as well as current nursing principles, practices, methods and procedures.
Understanding of crisis management/emergency care as related to nursing care.
Knowledge of applicable laws governing patient confidentiality.
Knowledge of general signs and symptoms of psychiatric illnesses.
Knowledge of medical terminology and insurance coding.
Understanding of the Utilization Review process.
Ability to organize and prioritize workloads to meet deadlines.
Ability to communicate effectively both orally and in writing.
Ability to interface with insurance companies, health care providers, patients and families.
Ability to complete necessary reviews for Utilization Review.
Ability to adhere to safety policies and procedures.
Ability to exercise sound judgment and to maintain confidentiality of information.
Ability to work individually or as a team player.
Ability to demonstrate tact, resourcefulness, patience and dedication.
Ability to adapt to the various patient age groups (child, adolescent, adult and geriatric).
Ability to work in a fast-paced environment.
Ability to meet mandated deadlines.
Ability to react calmly and effectively in emergency situations.
Graduate from an accredited program of professional nursing or masters degree in social work or MFTpreferred.
Three (3) years of experience in a mental health/health facility preferred.
Utilization Review experience preferred.
Current licensure as a Registered Nurse (RN), Licensed Practical Nurse (LPN) Licensed Clinical Social Worker (LCSW), or Marriage and Family Therapist (MFT) in the State of Nevada preferred.

Responsibilities

Performs admission reviews using the established specific criteria.
Performs concurrent reviews using the established specific criteria.
Performs retrospective reviews using the established program; forwarding records as requested.
Ensures information is accurate and timely.
Coordinates information and findings with the Business Office to recognize and resolve certification problems.
Schedules the completion of reviews to ensure a continuum of reviews, as per plan.
Increases proficiency through attendance of available in-service and seminar presentations related to UR, mental health diagnosis, and treatment