Responsibilities REPORTS TO: Director of Care Management POSITION PURPOSE: Provides ongoing and systematic utilization review; coordinates patient care to optimize financial and clinical outcomes; advocates for patient and facility; and promotes quality care and documentation. Coordinates assignments, appeals and discharge planning. KEY RESPONSIBILITIES: Admission and continued stay reviews to ensure that care meets the clinical needs of the clients and reduces financial risk to the facility. Participates in measures to improve the delivery and utilization of care and to evaluate the effectiveness of these. Expert in documentation, communication, teamwork, and customer service. Advocates for internal and external customers including the client, family, physician, Treatment Team and Managed Care Organization. Works in partnership with the Physician through rounds and staffing to facilitate compassionate patient communication and advocacy, effective Treatment Team planning and timely discharge planning. Provides a strategic link between the Managed Care Organization, Treatment Team goals and the financial aspects of care. Provides a strategic link between Facility and the Managed Care Organization through the verification of benefits, certification of admissions and communication with the Care Manager. Monitors and nurtures the professional relationship between this facility and other facilities served through the Mobile Assessment Team. Coordinates Denial Management in cooperation with Director of Care Manager. Qualifications QUALIFICATIONS: SKILLS, KNOWLEDGE AND ABILITIES: Good verbal and written skills. Ability to maintain confidentiality. Some knowledge of JCAHO and Champus standards. Computer skills and knowledge of basic case management/utilization review principles. EDUCATION: Bachelors in related field or High School Diploma and some college with 5 or more years of experience in mental health field. LICENSURE/CERTIFICATION: Prefer RN, LPC of LMSW. EXPERIENCE: Two years experience in mental health setting and previous experience in Case Management/Utilization Review. PHYSICAL REQUIREMENTS: * Correctable vision and hearing. * Must be capable of occasionally lifting 25 pounds and carrying medical records. * Must be able to write and record information, and accurately read medical records. * Must be able to spend 30% to 40% of time standing or walking between units. 60% to 70% of the time is spent sitting at a desk. * Telephone or public face-to-face contact is infrequent, but must be able to calmly handle frustrated or angry clients. 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.