UR COORDINATOR

Responsibilities

Spring Mountain Treatment Center is a 110-bed mental health facility providing acute crisis stabilization services for adults, teens, and children in a secure inpatient setting since 2001. Our individualized treatment includes a structured, therapeutic environment, intensive physician involvement and oversight, and daily group and educational programs. We provide a caring and healthy environment that gives individuals a chance to make positive changes.

Website:

Spring Mountain Treatment Center is currently seeking a dynamic professional to join our team as a full-time UR Coordinator. The Utilization Review Coordinator proactively monitors utilization of services for patients to optimize reimbursement for the facility.

Job Duties/Responsibilities:

• Acts as a liaison between managed care organizations and the facility professional clinical staff.

• Conduct reviews, in accordance with certification requirements, of insurance plans or other managed care organizations (MCOs) and coordinate the flow of communication concerning reimbursement requirements.
• Monitor patient length of stay and extensions and inform clinical and medical staff on issues that may impact length of stay.
• Gather and develop statistical and narrative information to report on utilization, non-certified days (including identified causes and appeal information), discharges and quality of services, as required by the facility leadership or corporate office.
• Conduct quality reviews for medical necessity and services provided.
• Facilitate peer review calls between facility and external organizations.
• Initiate and complete the formal appeal process for denied admissions or continued stay.
• Assist the admissions department with pre-certifications of care.
• Provide ongoing support and training for staff on documentation or charting requirements, continued stay criteria and medical necessity updates.
• Performs other duties as assigned/required by this position.

Benefits & Rewards Highlights:

• Challenging and rewarding work environment 
• Competitive Compensation & Generous Paid Time Off  (full-time and part-time positions)
• Excellent Medical, Dental, Vision and Prescription Drug Plans (full-time and part-time positions)
• 401(K) with company match and discounted stock plan 
• SoFi Student Loan Refinancing Program 
• Tuition savings to continue your nursing education with Chamberlain University
• Career development opportunities within UHS and its 300+ Subsidiaries! 
• Pet Insurance
• More information is available on our Benefits Guest Website:  

About Universal Health Services:

Headquartered in King of Prussia, PA, Universal Health Services, Inc. (NYSE: UHS) is one of the nation’s largest and most respected providers of hospital and healthcare services. Since our founding in 1979, UHS has grown steadily into a premier Fortune 500® corporation perennially recognized by multiple esteemed national rating entities. Through its subsidiaries, UHS operates inpatient acute care facilities, inpatient behavioral health facilities, outpatient and other facilities, nationwide virtual behavioral health services, an insurance offering, a physician network and various related services with physical locations in the U.S., Puerto Rico, Ireland and United Kingdom. .

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Qualifications

Requirements:

• Bachelor's degree in nursing, social work, psychology, health information management or other related healthcare field is required; Masters degree preferred.

• Knowledge of health care service delivery systems and third party reimbursement

• Knowledge of insurances and experience with authorizations required.
• Demonstrates clear and consistent understanding of admission and discharge functions.

• Must be thoroughly conversant with the principles of Utilization Review and Quality Assurance.

• Ability to follow both written and verbal instructions
• Understand and honor the established hospital rules, regulations and Policy and Procedures
• Good communication skills, i.e., reading, writing, and speaking
• Ability to follow both written and verbal instructions
• Good leadership qualities which includes self-control, patience, and empathy
• New hires are required to attend 1 full week of New Employee Orientation on day shift, normally 8:00 am – 4:30 pm Monday through Friday
• Must successfully pass background check (includes criminal history, Child Abuse and Neglect Registry, and ABI/FBI fingerprint check)

EEO Statement

All UHS subsidiaries are committed to providing an environment of mutual respect where equal employment opportunities are available to all applicants and teammates. UHS subsidiaries are equal opportunity employers and as such, openly support and fully commit to recruitment, selection, placement, promotion and compensation of individuals without regard to race, color, religion, age, sex (including pregnancy, gender identity, and sexual orientation), genetic information, national origin, disability status, protected veteran status or any other characteristic protected by federal, state or local laws.

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We are aware of a scam whereby imposters are posing as Recruiters from UHS, and our subsidiary hospitals and facilities. Beware of anyone requesting financial or personal information.

At UHS and all our subsidiaries, our Human Resources departments and recruiters are here to help prospective candidates by matching skill set and experience with the best possible career path at UHS and our subsidiaries. During the recruitment process, no recruiter or employee will request financial or personal information (e.g., Social Security Number, credit card or bank information, etc.) from you via email. Our recruiters will not email you from a public webmail client like Hotmail, Gmail, Yahoo Mail, etc.

If you suspect a fraudulent job posting or job-related email mentioning UHS or its subsidiaries, we encourage you to report such concerns to appropriate law enforcement. We encourage you to refer to legitimate UHS and UHS subsidiary career websites to verify job opportunities and not rely on unsolicited calls from recruiters.