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Utilization Review Coordinator - Call-in - Full-time / Part-time
•30 days ago
| Hours | Full-time, Part-time |
|---|---|
| Location | ewa beach, Hawaii |
About this job
Aloha and welcome to Kahi Mohala's Career Page.
To begin, we want to inform you of our application process which we call "On Boarding." The Onboarding begins with your on-line application for employment. If you meet the qualifications for the position, the department manager will notify you of a scheduled interview through your email address or by telephone.
Located on 14.5 park-like acres, Kahi Mohala's 88-bed facility is Hawaii's only private, freestanding psychiatric hospital. Kahi Mohala provides comprehensive behavioral health services for adults, adolescents and children experiencing problems with psychiatric disorders, anxiety, depression, eating disorders. The buildings and grounds offer a complete residential environment with an emphasis on patient safety and security.
POSITION SUMMARY : The Utilization Review Coordinator, under the general supervision of the Clinical Support Services Manager, coordinates all aspects of Utilization Management, working closely with Admissions, Administration, Patient Financial Services, Medical Staff, Social Work, Nursing, Marketing, and Outpatient Services. Serves as a clinical resource to the Risk Manager in the identification and investigation of potential claims and occurrence reports. The Utilization Review Coordinator will personally manage all appeals. Provides education to physicians and nurses on elements of documentation to support authorizations at least annually. The incumbent will also perform special projects as assigned. This is a salaried, full time (32-40/wk) exempt position .
The Utilization Review Coordinator reports to the Clinical Support Services Manager as does the Utilization Reviewer, Psychiatric Assessment Specialist/Nurse Screener, Call Center Coordinators, Registered Health Information Specialist, and Medical Records Analyst.
Education: Graduate of an accredited school of nursing and currently licensed as an RN by the State of Hawaii. BSN with managed care experience preferred. Certification in Utilization Review valued and encouraged.
Experience: Seasoned inpatient psychiatric experience. Managed care/utilization review and quality assurance experience.
Knowledge: Knowledge of utilization management review guidelines and regulations, familiarization with JCAHO standards, knowledge of state regulations, familiarity with Managed Care standards. Knowledge of community standards, case management, knowledge of performance improvement standards and its relationship to risk management.
Specials Skills/Equipment: Effective verbal communication, excellent telephone skills/etiquette. Must be computer literate, able to prioritize, delegate and problem solve.
Physical Requirements: Must meet basic health requirements of Kahi Mohala physical examination including TB skin test or chest x-ray.
To begin, we want to inform you of our application process which we call "On Boarding." The Onboarding begins with your on-line application for employment. If you meet the qualifications for the position, the department manager will notify you of a scheduled interview through your email address or by telephone.
Located on 14.5 park-like acres, Kahi Mohala's 88-bed facility is Hawaii's only private, freestanding psychiatric hospital. Kahi Mohala provides comprehensive behavioral health services for adults, adolescents and children experiencing problems with psychiatric disorders, anxiety, depression, eating disorders. The buildings and grounds offer a complete residential environment with an emphasis on patient safety and security.
POSITION SUMMARY : The Utilization Review Coordinator, under the general supervision of the Clinical Support Services Manager, coordinates all aspects of Utilization Management, working closely with Admissions, Administration, Patient Financial Services, Medical Staff, Social Work, Nursing, Marketing, and Outpatient Services. Serves as a clinical resource to the Risk Manager in the identification and investigation of potential claims and occurrence reports. The Utilization Review Coordinator will personally manage all appeals. Provides education to physicians and nurses on elements of documentation to support authorizations at least annually. The incumbent will also perform special projects as assigned. This is a salaried, full time (32-40/wk) exempt position .
The Utilization Review Coordinator reports to the Clinical Support Services Manager as does the Utilization Reviewer, Psychiatric Assessment Specialist/Nurse Screener, Call Center Coordinators, Registered Health Information Specialist, and Medical Records Analyst.
Education: Graduate of an accredited school of nursing and currently licensed as an RN by the State of Hawaii. BSN with managed care experience preferred. Certification in Utilization Review valued and encouraged.
Experience: Seasoned inpatient psychiatric experience. Managed care/utilization review and quality assurance experience.
Knowledge: Knowledge of utilization management review guidelines and regulations, familiarization with JCAHO standards, knowledge of state regulations, familiarity with Managed Care standards. Knowledge of community standards, case management, knowledge of performance improvement standards and its relationship to risk management.
Specials Skills/Equipment: Effective verbal communication, excellent telephone skills/etiquette. Must be computer literate, able to prioritize, delegate and problem solve.
Physical Requirements: Must meet basic health requirements of Kahi Mohala physical examination including TB skin test or chest x-ray.