Coord - Case Mgmt​/Utiliz Rev

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

This is a full‑time, day‑shift position (Monday–Friday, 8:00 am–4:30 pm). The (LVN/LPT) Utilization Review Coordinator reports to the Social Services Supervisor and Director of Behavioral Health Services, ensuring 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, verifies case documentation and medical necessity of treatment per federal, state, and county regulations, assesses continuing treatment plans, and advocates for required patient treatment with medical providers.

Croner's Regional Medical Center, established in 1965, has evolved into a 238‑bed community hospital network consisting 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.

• Oversee and coordinate utilization review activities for the inpatient acute psychiatric unit.
• Proactively monitor documentation and reimbursement for services provided.
• Review medical records of patients to ensure proper utilization of facility resources.
• Verify case documentation and medical necessity in accordance with federal, state, and county regulations.
• Assess continuing treatment plans.
• Advocate for required patient treatment with medical providers.

Essential Knowledge / Skills

• Familiar with healthcare delivery system, Medicare and Medi‑Cal reimbursement guidelines; knowledge of applicable state, federal and third‑party regulations and standards.
• Experience with the appeal process.
• Excellent verbal and written communication skills; assertive, persistent, and persuasive.
• Understanding of admission and discharge criteria.
• Familiarity with medical terminology, treatment modalities, and diagnostic terminology.
• Flexible, detail‑oriented, responsive to deadlines.
• Strong interpersonal, organizational, and time‑management skills, requiring minimal supervision.

Computer Skills

• Strong computer skills required.

Minimum Essential Experience & Education

• Significant utilization review experience required, minimally one year.
• Assaultive behavior management training (MAB) required within 90 days of hire.

Required Licensure / Certifications

• 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 requiring 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.