Coord - Case Mgmt​/Utiliz Rev

Responsibilities

Utilization Review Coordinator
- Psychiatric Unit
* BONUS
* at Corona Regional Rehabilitation Hospital in Corona, CA

This is a full-time, day shift position working from Monday-Friday 8:00 am - 4:30 pm.

The (LVN/LPT) Utilization Review Coordinator in our Psychiatric Unit reports to the Social Services Supervisor and Director of Behavioral Health Services. This position ensures oversight and coordination of utilization review activities, proactively monitoring documentation and reimbursement for services provided in the inpatient acute psychiatric unit. The coordinator reviews medical records of patients admitted for psychiatric/mental illness to ensure proper utilization of facility resources, conducts record reviews to ensure proper case documentation and medical necessity of treatment in accordance with Federal, State, and County regulations;

assesses continuing treatment plans and advocates for required patient treatment with medical providers.

The tradition of caring that culminated in the establishment of Corona Regional Medical Center® began in 1965, with the founding of Corona Community Hospital. Since that time the hospital has changed to meet the needs of the rapidly growing community. Corona Community Hospital merged with Circle City Medical Center in 1992 and the resulting entity became Corona Regional Medical Center. The merged hospitals are now a 238-bed community hospital network comprised of a 160-bed acute care hospital and a 78-bed rehabilitation campus.

It is certified by The Joint Commission, employs more than 1,250 trained healthcare workers and has a medical staff of approximately 347 physicians representing more than 40 specialties.

• Familiar with the Healthcare Delivery System, Medicare and Medi-Cal reimbursement guidelines; knowledge of applicable State, Federal and 3rd party regulations/standards required.
• Knowledgeable and experienced with the appeal process.
• Excellent verbal and written skills; assertive, persistent and persuasive.
• Understanding of admission and discharge criteria.
• Familiarity with medical terminology, treatment modalities and diagnostic terminology.
• Flexible, maintains attention to detail and responsiveness to deadlines.
• Strong interpersonal, organizational and time management skills, requiring minimal supervision.
• Strong computer skills required.

• Significant Utilization Review experience required, minimally one year.

• Assaultive behavior management training (MAB) required within 90 days of hire.

• Current California License LVN/LPT.
• Current CPR Certificate from the American Heart Association.

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.

To encourage pay transparency, promote pay equity, and proactively address regulations, UHS and all our subsidiaries will comply with all applicable state or local laws or regulations which require employers to provide wage or salary range information to job applicants and employees. A posted salary range applies to the current job posting. Salary offers may be based on key factors such as education and related experience.