Utilization Mgmt Coord - Behavioral Health

Responsibilities

• Makes sure admitted patients get the right kind of care and are ready for treatment.
• Makes sure the patient is making progress in their treatment plan and meets the need for more care.
• Makes sure the patient’s insurance company has all the important information needed to approve the behavioral health services and continue the patient’s stay.

Qualifications

• Bachelor’s Degree from an accredited nursing school, B.A/ B.S or Bachelor’s Degree in Social Work Required
• Two years of experience in acute, post-acute, managed care, psychiatric, or revenue cycle settings Required
• Experience with InterQual and/or MCG guidelines Required
• Experience in Utilization Management and/or Appeals Required
• Experience with Epic or Meditech/MIDAS systems Required
• Experience in prior authorization process Required
• Utilization Review or Care Management experience Preferred
• Current unrestricted registered nurse (RN) license or LMSW/LCSW, in the state of Georgia. Required or LPC/LMFT also acceptable
• Case Management Certification (CCM) or American Case Management Association (ACMA) certification Preferred