Dover Behavioral Health System is seeking a Full-Time Utilization Review Coordinator. The incumbent will be responsible for proactively monitoring utilization of continuum services and optimize reimbursement.

Key Responsibilities include:

• Conduct admission reviews working with Assessment and Referral Services to stay abreast of admissions.
• Conduct concurrent and extended stay reviews on appropriate day and/or specified time.
• Prepare and submit appeals to third party payors, effectively coordinating collection of all pertinent data to support the hospital and patient’s position.
• Call/fax discharge information to insurance companies within 24 hours of discharge to ensure the facility is paid for the hospital stay.
• Maintain and update logs of review and maintain other appropriate records of the Utilization Review department.
• Communicate pertinent third party payors issues to doctor and treatment team.
• Attend daily treatment team meetings to discuss acuity issues, third party payors needs and gather information for reviews.
• Work independently in gathering information for reviews from the patient record, taking the initiative to seek information from members of the treatment team.
• Understand and communicate insurance information to team members, including benefits and levels of care offered.
• Perform internal utilization reviews as indicated.
• Prepare any reports assigned or requested by COO.
• Identify, document, and report any and all instances of adult or child abuse and neglect to the appropriate parties including a member of management, the police, and state agencies

• MSW or MS in a recognized mental health field or Registered Nurse
• A minimum of one year experience in case management and/or hospital experience

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.

We believe that diversity and inclusion among our teammates is critical to our success.

Notice

At UHS and all our subsidiaries, our Human Resources departments and recruiters are here to help prospective candidates by matching skillset and experience with the best possible career path at UHS and our subsidiaries. We take pride in creating a highly efficient and best in class candidate experience. During the recruitment process, no recruiter or employee will request financial or personal information (Social Security Number, credit card or bank information, etc.) from you via email. The recruiters will not email you from a public webmail client like Hotmail, Gmail, Yahoo Mail, etc. If you are suspicious of a job posting or job-related email mentioning UHS or its subsidiaries, let us know by contacting us at: https://uhs.alertline.com or 1-800-852-3449.