COORD - CASE Mgmt​/Utiliz REV: Acute Locked Psych Unit - thru Day shift

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 will report to the Social Services Supervisor and Director of Behavioral Health Services. This position assures oversight and coordination of utilization review activities, proactively monitoring documentation and reimbursement for services provided in the inpatient acute psychiatric unit.

The Utilization Review Coordinator reviews medical records of patients admitted for psychiatric/mental illness to ensure proper utilization of facility resources, conducts review of patient records 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. Corona Regional Medical Center is a 238-bed community hospital network comprising 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.

ESSENTIAL KNOWLEDGE / SKILLS

• Case Management Experience Required, minimally one year
• Familiar with the Healthcare Delivery System, Medicare and Medi-Cal reimbursement guidelines; knowledgeable 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 persuasiveness
• 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

MINIMUM ESSENTIAL EXPERIENCE

• Significant Utilization Review experience required, minimally one year.

MINIMUM ESSENTIAL EDUCATION

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

REQUIRED LICENSURE / CERTIFICATIONS

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

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We believe that diversity and inclusion among our teammates is critical to our success.

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