Utilization Review Coordinator - Full Time | Voyages Sugar Land

Voyages Behavioral Health of Sugar Land•Sugar Land, TX

About The Position

At Voyages Behavioral Health/ PAM Health, we care for chronically and critically ill patients who require extended hospital care. PAM Health has over 80 hospital locations and employs over 11,000 people across the country. Our teams work together to deliver the highest level of compassionate care ensuring the best possible outcome for our patients. What can we offer you as a full-time employee? Voyages Behavioral Health is committed to being the most trusted source for behavioral health services in every community it serves by utilizing experienced and dedicated staff to provide high quality patient care and customer service. As an affiliate of PAM Health , our organization has more than 80 long-term acute care hospitals and physical medicine and rehabilitation hospitals, as well as wound clinics and outpatient physical therapy locations, in 17 states, proudly offering services including comprehensive wound care, aquatic therapy, ventilator weaning, amputation treatment, pain management and now Behavioral Health, inpatient, outpatient, and ECT service lines. Joining our PAMily allows you to work in a collaborative environment with colleagues and leadership with exposure to a variety of patient care levels. Aside from our competitive pay, generous paid benefit time, and excellent insurance options, you will also have opportunities for professional growth through our Education Advancement Program. We are excited to learn more about you and hope that you consider joining us on a shared mission to improve the lives of others by being an integral part of our We Care Program. Please take a moment to visit us online at www.voyageshealth.com for a comprehensive look at how we're able to positively impact our local communities. Voyages Behavioral Health does not discriminate and does not permit discrimination, including, without limitation, bullying, abuse or harassment, on the basis of actual or perceived race, color, religion, national origin, ancestry, age, gender, physical or mental disability, sexual orientation, gender identity or expression or HIV status, or based on association with another person on account of that person's actual or perceived race, color, religion, national origin, ancestry, age, gender, physical or mental disability, sexual orientation, gender identity or expression or HIV status.

Requirements

Masters or bachelor's degree in nursing, social work, mental health/behavioral sciences, or related field required.
Licensed if applicable in the state in which the hospital resides.
Current BLS certification required.
Crisis management certification per hospital policy and standards required.
One to three years of acute care behavioral health management provided to a wide range of demographics and ages preferred.

Responsibilities

Under the direction of the Director of Utilization Review, the responsibilities of the Utilization Review Coordinator are to manage the review of assigned admissions, continued stays, utilization practices and discharge planning according to the approved clinically valid criteria.
The Utilization Review Coordinator will review clinical content of medical record, participate in treatment team meetings, collaborate with physicians, therapist, nurses and pertinent staff on gathering the necessary data to communicate with insurance companies/authorizing entities to ensure initial precertification and continued authorization is achieved.
Utilization Review Coordinator will ensure reviews and analysis of pre-certifications and continued stay reviews, follow-up on unfinished pre-certifications from the day before and coordinate with the treatment team on any follow-ups necessary.
The Utilization Review Coordinator will be trained in all aspects relative to timely gathering of clinical criteria, communication of clinical criteria, and entry of supporting clinical criteria into computer-based systems.
This position will contribute to department meetings, quality initiatives and maintain services within TJC requirements.

Benefits

Medical benefits: EPO/HDHP/HSA options, including prescription coverage, Rx ’n Go, and Teladoc
Comprehensive dental and vision benefits
Employee Assistance Program, including counseling, legal, and financial services
Flexible spending (FSA) and health savings (HSA) accounts
Life and Disability insurance benefits
Education/In-Service Opportunities including continuing education and tuition assistance
Supplemental benefits: Accident, critical illness, cancer, pet, and identity theft protection insurance options
Auto, Home, Cell Phone, and Gym Membership discount offerings
Personal Travel Discounts
401(k) plans and discretionary employer match
Generous Paid Benefit Time