Job Abstract

Join Cottage Health as the per diem Psych Utilization Review Coordinator. The Psych Utilization Review Coordinator is responsible for coordinating and obtaining initial, concurrent, and post discharge treatment authorizations from insurance companies and managed care organizations. Communicates authorization status to treatment members, residents and families as needed, reviewing intensity of service/illness to insure appropriate level of care is being met. Coordinates MD to MD reviews, initiates written appeals and denials. Communicates authorization status with admitting and business office to insure payment.

QUALIFICATIONS

All job qualifications listed indicate the minimum level necessary to perform this job proficiently.

LEVEL OF EDUCATION

Minimum: ASN or Master’s Degree in Psychology, Counseling or Social Work

Preferred: BA in Nursing

CERTIFICATIONS, LICENSES, REGISTRATIONS

Minimum: MFT, LCSW, or RN is required

TECHNICAL REQUIREMENTS

Minimum: Computer Skills, MS Office Word, Excel

Preferred: On the job training in CPOE, electronic health record, ASAM Criteria

YEARS OF RELATED WORK EXPERIENCE

Minimum: 5 years in providing Psych/CD services in an insurance based system.