UR COORDINATOR

UHS • $104K — $114K *
Madera, CA 93638In-Person
Healthcare
Less than 5 years of experience
Today
Be an Early Applicant
Job Overview by Ladders

Qualifications

  • Bachelor's Degree in Nursing, Psychology, or Social Work; Master's preferred
  • CA RN license required; License in Social Work, AMFT, or Mental Health Counseling preferred
  • 3-5 years in an acute inpatient psychiatric setting as a treatment team member or in utilization management
  • Proficient in behavioral health managed care and clinical assessment skills using DSM-V
  • Strong oral and written communication skills for patient advocacy and payer negotiations
  • Solid understanding of acute inpatient psychiatric hospital operations for mental health and substance abuse treatment

Responsibilities

  • Perform daily clinical reviews with various payer types to secure authorization for continued treatment
  • Act as a key member of the multidisciplinary team to educate on level of care requirements and payer expectations
  • Complete appeal and denial letters timely, participating in post-claim recovery reviews
  • Collaborate with hospital operations to ensure documentation aligns with patient conditions
  • Report on monthly utilization data trends using hospital data tools
  • Facilitate physician reviews with payers as necessary
  • Perform additional duties as assigned

Benefits

  • Service excellence emphasis, promoting positive guest interactions
  • Professional growth opportunities with a focus on teamwork and continuous improvement practices
  • Supportive environment encouraging effective communication and decision-making
  • Engagement in a multidisciplinary treatment approach leading to diverse learning experiences
Full Job Description
Responsibilities

Position Summary:

Facilitates a continuum of service while promoting positive outcomes and optimal reimbursement through coordination of patient care, daily clinical reviews, quality documentation, appeals, and reporting.

QUALIFICATIONS

Education: Bachelor's Degree in Nursing , Psychology, or Social Work. Master's preferred.

Licensure: CA RN license required. License in Social Work, AMFT, Mental Health Counseling preferred

Experience : A minimum of 3-5 years of experience working in an acute inpatient psychiatric setting as a treatment team member and/or utilization management, or years of utilization management experience

RN pay ranges- $50-$55

SW pay ranges- $37-$42

Qualifications

  • Knowledgeable in behavioral health managed care and clinical assessment skills to align patient acuity with level of care practice guidelines - Diagnostic and Statistical Manual of Mental Disorders (DSM-V).
  • Effective oral and written communication skills to support patient advocacy/negotiating skills to ensure quality reviews with payers
  • Solid understanding of acute inpatient psychiatric hospital operations, including both mental health and substance abuse treatment.

    • Essential Job Duties/Responsibilities

  • Performs timely, daily clinical reviews with all payer types (Managed Medicare, Managed Medicaid and commercial) to secure authorization for continued treatment (i.e. by fax, telephone or on-line) based on the payer's criteria.
  • Functions as a key member of the multidisciplinary treatment team to educate and guide on level of care requirements and payer expectations for patient acuity and appropriate utilization.
  • Completes quality and timely appeal/denial letters. Participates in post claim recovery review and ongoing audit activity, supporting compliance with CMS and other regulators
  • Works collectively with hospital operations (social services, business office, Intake, Nursing) to ensure timely documentation is aligned with patient conditions.
  • Contributes to monthly utilization data trends using hospital data tools to report for the overall operation
  • Facilitates physician reviews with payers as required
  • Performs other duties as assigned/required by this position


    • Service Excellence.

    Service excellence is a part of all we do. Our standards include:
    • Treat everyone as a guest by making a good first impression, anticipating needs and displaying service recovery skills.
    • Demonstrate professionalism and excellence by looking professional, being accountable for actions and delivering excellence in our everyday work.
    • Practice teamwork by participating in decision making and process improvement, communicating effectively and focusing on the problem/issue, not the person.

    About UHS

    UHS Careers

    Joining UHS presents an unparalleled opportunity to become part of a leading team of healthcare professionals dedicated to making a difference. UHS, known for its commitment to innovation and leadership in the healthcare sector, offers a variety of job opportunities that cater to a diverse range of skills and experiences.

    Explore Job Opportunities

    UHS is actively hiring and offers a wide array of positions, from clinical roles to administrative support. Each position at UHS is designed to challenge team members while providing meaningful service to the community. Explore the current job openings and find a career path that suits professional aspirations and skills.

    Internship Programs

    UHS provides robust internship programs that offer hands-on experience in the healthcare industry. Internships are a cornerstone of professional development, giving participants a chance to deepen practical skills in a real-world setting. These programs are tailored to foster growth and prepare interns for a full-time position within the company.

    Professional Growth and Development

    UHS believes in nurturing the career growth of its team members through comprehensive professional development programs. These include leadership training, diversity training, and continuous education in the latest healthcare practices, ensuring that every team member has the opportunity to advance their career.

    Benefits and Culture

    Employment at UHS comes with competitive benefits designed to support the health, well-being, and financial security of each team member and their families. The company culture at UHS is built on a foundation of respect and inclusion, where diversity is celebrated and every voice is heard.

    Networking and Innovation

    UHS encourages a culture of innovation where team members are motivated to bring forward ideas that drive improvement and efficiency. Networking within the company is supported through various events and internal platforms, helping team members to connect, share insights, and collaborate on projects.

    Applying for a Position

    To apply for a position at UHS, candidates should prepare their resume to highlight relevant experience and skills. The interview process at UHS is thorough, aiming to assess not only the professional qualifications but also the alignment with the company’s values and culture. Interested candidates can visit the UHS Careers page to submit an application and learn more about the hiring process.

    Stay Connected with UHS Careers

    Keep up to date with the latest from UHS Jobs and Careers through the company’s dedicated careers blog. Subscribe to receive updates on new job opportunities, employment tips, and insights into the healthcare industry directly from the professionals at UHS.

    Join UHS

    Discover the rewarding career opportunities at UHS. Search for open positions that match individual skills and interests. UHS looks for passionate, curious, and solution-driven team players ready to make a significant impact in the healthcare sector.

    SEARCH UHS JOBS

    READ CAREERS BLOG

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    Learn more about UHS
    Industry
    Hospitals & Medical Centers
    * Ladders Estimates

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