Recruitment/Posting Title Utilization Management Coordinator Job Category Staff & Executive - Other Department UBHC-P-VICE PRES & CEO-PISC Overview Rutgers University Behavioral Health Care (UBHC), established in 1971, offers a full continuum of evidence based behavioral health and addiction services for children, adolescents, adults, and seniors throughout New Jersey. UBHC’s 1,060 experienced behavioral health professionals and support staff are dedicated to treatment, prevention, and education. UBHC, one of the largest providers of behavioral health care in the country, has a budget of $260 million and has 15 sites throughout New Jersey. Services are readily accessible and include: inpatient, outpatient, partial hospitalization, screening, crisis stabilization, family/caregiver support, community outreach and case management, supportive housing, supported employment, prevention and consultation, employee assistance programs, and a licensed therapeutic school from preschool through high school. Specialty services include the New Jersey suicide prevention helpline and peer help lines for police, veterans, active military, teachers, mothers of special needs children and child protective service workers. In FY2016, UBHC treated 16,199 consumers, had 24,502 admissions, and touched the lives of 19,441 individual callers through peer support. In addition, UBHC is the primary mental health training resource for the New Jersey departments of Human Services, Children and Families, and Corrections, delivering 16,000 trainings each year.  Posting Summary Rutgers, The State University of New Jersey is seeking a Utilization Management Coordinator for the Utilization Management Department within Rutgers University Behavioral Health Care.

The primary purpose of the Utilization Management Coordinator is to conduct utilization reviews to ensure that clinical services meet medical necessity and all applicable standards for regulatory funding and accrediting agencies.

Among the key duties of this position are the following:

Conducts certification, pre-certification and continuing certification requirements for Medicaid, Medicare and insurance clients. Effectively communicates outcomes of precertification and concurrent reviews to appropriate members of the treatment team, leadership and UR Supervisor. Communicates routinely with UR Supervisor regarding specific reimbursement issues. Serves as resource for treatment team related to medical necessity interventions and documentation. Assists treatment team members in discharge planning in obtaining authorization for the next level of care as needed. Participates in data collection related to patient status and needs. Identifies and reports quality-of-care issues/concerns to supervisor. Ensures that insurance information is current with background investigation if no insurance card available. Performs data entry of assigned cases in a timely manner. Position Status Full Time Hours Per Week Daily Work Shift Work Arrangement Consistent with the current application of Rutgers Policy 60.3.22 or the applicable provisions of relevant collective negotiations agreements, this position may be eligible for a hybrid work arrangement. Flexible work arrangements are not permanent, are subject to change or discontinuation, and contingent on the employee receiving approval in the FlexWork@RU Application System.  FLSA Exempt Grade 25S Position Salary Annual Minimum Salary 70041.00 Annual Mid Range Salary 84083.00 Annual Maximum Salary 99858.00 Standard Hours 37.50 Union Description HPAE 5094 Payroll Designation PeopleSoft Benefits Rutgers offers a comprehensive benefit program to eligible employees. For details, please go to http://uhr.rutgers.edu/benefits/benefits-overview.



Seniority Unit Terms of Appointment Staff - 12 month Position Pension Eligibility ABP