Utilization Review; UR Coordinator

Responsibilities

Granite Hills Hospital offers high-quality, patient centered behavioral health care for the greater Milwaukee community. Our 120-bed facility will feature evidence-based treatment for adolescents, adults, and older adults.

We are looking for a Full Time Utilization Review (UR) Coordinator to join our new team.

The UR Coordinator has responsibility for organizing and conducting the managed care process. The duties shall be directed toward supporting the hospital's mission in the pursuit of excellence in care/service and will include (but not limited to): conducting timely admission and continued stay record reviews with external payers, utilizing approved criteria to make determinations of medical necessity and level of care planning, verifying active treatment by completing internal audit reviews within approved time frames, assisting the treatment team when indicated in the discharge planning process, and acting as liaison with MD/Clinical Treatment Team and external agencies.

Report authorizations, denials, and documentation concerns, as well as collaborate effectively across departments to minimize denials/facilitate optimal use of hospital resources.

• Competitive Compensation
• Excellent Medical, Dental, Vision, and Prescription Drug Plan
• Generous Paid Time Off
• 401(K) with company match and discounted stock plan
• Career development opportunities within UHS and its subsidiaries
• Education Assistance
• Challenging and rewarding work environment

Interested applicants may apply directly through our website  and apply through the Careers tab.

Education: Bachelor degree in social work, psychology, or counseling. Master’s degree in social work, psychology, or counseling preferred.

LPN/LVN required. ADN, BSN preferred.

Limited or full licensure is preferred.

Experience: Experience in psychiatric or substance abuse treatment preferred. Hospital utilization review/utilization management experience required. Experience in settings that include inpatient or partial hospitalization preferred. Familiarity with managed health care process, medical terminology, experience in case management, discharge planning, and/or utilization review preferred.

Must possess a valid Driver’s License.

Prefer knowledge of the Milwaukee behavioral health marketplace, insurance plans, target markets and referral sources, psychiatric and chemical dependency treatment and age-specific programming.

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.