UR COORDINATOR- FULL TIME

Utilization Review Coordinator

River Oaks Hospital, located in metropolitan New Orleans, Louisiana, is a private psychiatric facility for adults, adolescents, and children. Since 1970, River Oaks has established a tradition of excellence in the treatment of acute psychiatric illness, dual diagnosis, alcohol and drug detoxification, trauma based disorders, compulsive behaviors, and eating disorders. River Oaks Hospital is seeking a dynamic and talented Utilization Review Coordinator who evaluates patient medical records to determine severity of patient's illness and the appropriateness of level of care. Serves as liaison for patients and facility with insurance companies. Negotiates and advocates for patient length of stay and level of care. Coordinates utilization review activities with other departments to ensure reimbursement for services provided by the facility. Promotes patient care consistent with the philosophy and objectives of River Oaks Hospital. Performs duties in accordance with the ANA Standards of Practice for Psychiatric Mental Health Care, and facility mission, values, policies, and behavioral standards.

Qualifications: Minimum qualifications required include 3-5 years of experience working in an acute inpatient psychiatric setting as a treatment team member and/or utilization management, or a minimum of three years utilization management experience within a payer organization. Education: Bachelors prepared healthcare professional (Nursing, Counseling, Psychology or Social Work) Masters preferred. Working knowledge of psychiatric care, utilization review, insurance reimbursement procedures, DSM-V, etc. Current knowledge of regulating/accrediting agency guidelines. Basic knowledge of statistical analysis desired.