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Connections Health Solutions

We provide crisis stabilization and access to care for anyone needing behavioral health services.

Utilization Management Coordinator

AdministrationAdministrationFull TimeRemoteMid LevelTeam 501-1,000Since 2009H1B No SponsorCompany SiteLinkedIn

Location

United States

Posted

6 days ago

Salary

0

Seniority

Mid Level

No structured requirement data.

Job Description

Utilization Management Coordinator

Connections Health Solutions

Role Description The Utilization Management Coordinator pursues and secures authorizations from any and all payers. Ensures appropriate utilization of services at Connections Health Solutions clinics, observation and inpatient units. Facilitates maximum appropriate payment through support of concurrent review of inpatient care by any payer. Obtains prior authorization for service as required. - Works with all payers to secure authorization for inpatient stays for all individuals admitted to Inpatient or COE Unit. - Performs utilization review in accordance with all Payor requirements, State Regulations, and Joint Commission Standards. - Ensures all payer utilization management staff receive needed daily information to perform their reviews. - Obtain authorizations for previously identified procedures where required. - Reviews medical records and evaluates patient progress towards discharge. - Performs continuing review on medical records and identification and need for on-going inpatient services. - Obtains necessary medical reports, treatment plans and validates BHMP’s progress notes/evaluations for appropriate justifications of continued stay. - Documents review information as required by State and Payor regulations. - Communicates results to applicable payor sources, including requests to BHMP’s for expedited follow-up to all payer UM staff. - Complies with regulation changes affecting utilization management. - Facilitates educational programs and advises physicians and other departments of regulations affecting utilization management. - Performs all other duties as assigned. This is a fully remote position in these states: AL, AR, AZ, CA, CO, CT, DC, FL, GA, IA, IL, IN, KS, KY, LA, MA, MD, ME, MI, MN, MT, NC, NJ, OH, OR, PA, RI, SC, TN, TX, UT, VA, WA. Qualifications - High School Diploma or equivalent - At least 2 years of behavioral health experience - Expertise in Utilization Management responsibilities, tasks and functions, and/or Clinical auditing experience Requirements - The Company has a mandatory vaccination policy. All successful applicants must be fully vaccinated, including showing proper documentation, or otherwise be exempt pursuant to the Company’s exemption process prior to their start date as a condition of employment. Benefits - Full-time only: Employees (and their families) are offered comprehensive health insurance, including Medical, Dental, Vision, Accident, Critical Illness, and Hospital Indemnity. - CHS pays for Basic Life, AD&D, Short and Long-Term Disability. - Voluntary Life insurance option for employees and their families. - Health Savings Accounts (with $1,000 to $2,000 employer contribution depending on plan). - Flexible Spending Accounts (health care and dependent care). - 401k company match after 6 months (50% of deferrals up to 6% of compensation). - Generous PTO starting at 160 hours accrued annually and 12 recognized company holidays. - Company‑paid parental leave available to eligible employees. - All employees (Pool, Part-time and Full-time): Employee Assistance Program to help with confidential emotional support, work life solutions, financial solutions, legal assistance, or online support. - After 90 days, you are auto enrolled in the 401k Plan.

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