Utilization Management Coordinator
Universal Health Services
Utilization Management Coordinator
Universal Health Services
Manages hospitals and behavioral health facilities
Hartgrove Behavioral Health System is a 160-bed leading psychiatric hospital dedicated to providing quality behavioral health services for its diverse population of children, adolescents and adults. Hartgrove Hospital has become the flagship behavioral health facility within Universal Health Services, Inc., its parent company. As a leader in behavioral health within UHS and in the Chicago area, Hartgrove Hospital is a state-of-the-art facility offering some of the most advanced technologies and programs found in the behavioral health field. We are dedicated to our teamwork approach and provide a compassionate and therapeutic environment, as well as offering a continuum of specialty programs throughout our inpatient, partial and outpatient services.
The Utilization Management Coordinator performs timely, daily clinical reviews with all payer types, to secure authorization for initial and continued treatment based on payer’s criteria and in accordance with the hospital wide Utilization Management Plan. Serves as liaison to 3rd and 4th party reviewers, effectively coordinating collection of all supporting data to support the hospital and patients’ position. 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 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. Maintains all records/data pertaining to the Utilization Management Program. Actively participates in Utilization Management/Medical Records Committee meetings including presentation of reports, statistics, etc. Participates in the hospital-wide Quality Assurance Program.
Job Duties:
Benefit & Reward Highlights:
A Career with Hartgrove Behavioral Health System Offers....
For information about the benefits we offer, please visit UHS Benefits Service Center.
About Universal Health Services
One of the nation’s largest and most respected providers of hospital and healthcare services, Universal Health Services, Inc. (NYSE: UHS) has built an impressive record of achievement and performance, growing since its inception into a Fortune 500 corporation. Headquartered in King of Prussia, PA, UHS has 99,000 employees. Through its subsidiaries, UHS operates 28 acute care hospitals, 331 behavioral health facilities, 60 outpatient and other facilities in 39 U.S. States, Washington, D.C., Puerto Rico and the United Kingdom
Education: Bachelor’s Degree in behavioral health related field required; Master Degree preferred. LCPC, LCSW, LPC, LSW, LMFT, RN or CADC preferred
Experience: 1 or more years of experience in Utilization Management preferred
Knowledge: Possesses knowledge of utilization review, insurance and managed care procedures. Current knowledge of regulating /accrediting agency guidelines. Basic knowledge of computer skills and statistical analysis desired. 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
Work Schedule: Full-time,Days; Weekly work schedule features 3 full day shifts, one half-day shift during the week, and one weekend half shift on Saturday or Sunday
Work Location: On-site at Hartgrove Behavioral Health Hospital (Chicago, IL)
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.
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Manages hospitals and behavioral health facilities
Universal Health Services operates a network of acute care hospitals, behavioral health facilities, and ambulatory centers across the United States. It generates its services by acquiring and managing healthcare facilities, then integrating them under centralized operating practices to deliver patient care. The company’s offering is the management and provision of hospital and behavioral health services, with a focus on standardized clinical operations, economies of scale, and nationwide coverage. What sets UHS apart is its long history of growth through acquisitions, its size and scale in both acute and behavioral health markets, and its ability to integrate new facilities while maintaining consistent care quality. Its goal is to provide high-quality healthcare across a broad network, improve patient outcomes, and sustain long-term value for shareholders by expanding access and efficiency in hospital and behavioral health services.
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