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AdventHealth Behavioral Health Utilization Coordinator RN or Social Worker/Therapist in Shawnee, Kansas

Description

Behavioral Health Utilization Coordinator RN or Social Worker/Therapist

Location Address: 9100 W. 74th Street, Mission, KS 66204

Top Reasons To Work At AdventHealth Shawnee Mission

  • Received Magnet® recognition from the American Nurses Credentialing Center in January 2019

  • Providing faith-based, whole person care to Kansas City since 1962

  • Excellent health benefits, an onsite child care center and fitness facility

  • Tuition reimbursement to support continuing education

  • Employee Referral Program

  • Largest health care provider in Johnson County with three campuses

Work Hours/Shift

  • 20 hours per week. 8 am to 12pm

  • Hours are very flexible as long as the hours occur before 2pm

You Will Be Responsible For:

  • Demonstrates ethical practices related to utilization management function • Maintains records and compiles stats as required • Implements appropriate intervention for admission denials or questionable continued stay necessity • Facilitates education of medical and hospital staff regarding UR concerns and processes • Insurance reviews completed in a timely manner • Responsible for participation in required staff in-service, training and education programs • Completes special projects, internally and externally for the successful and efficient operation of the facility as assigned • Opt-In participation in Emergency Notification System as applicable to facility • Performs other duties as assigned

Qualifications

What You Will Need:

Strongly Preferred:

• Basic understanding of the current Diagnostic Statistical Manual and ICD codes

• Working knowledge of treatment modalities of psychiatric patients

• Working knowledge of payer sources including commercial insurance, Medicaid and Medicare

• Basic computer skills and knowledge of Microsoft Office

• Must be able to read, write and speak conversational English

• Bachelor’s degree in Nursing

• Three years of clinical experience in an acute care setting

Required:

  • Licensed Nurse or Licensed Mental Health Counselor

  • CPR Card

Job Summary:

The Behavioral Health Utilization Coordinator ensures that all insurance authorization reviews are initiated promptly and performs the subsequent reviews in a timely manner. Keeps track of and appeals all insurance denials. Also assists in coordination of discharge planning, i.e., to residential treatment center, state facility, etc. Responsible for reporting problems to supervisor and/or Business/Case Manager. Scope of services will cover patients of all ages. Coordinator plans, organizes, coordinates, implements and evaluates quality review activities. Monitors admissions, screens and collects data that profiles the appropriateness and quality of patient care in an acute hospital setting, communicates with physicians regarding insufficient documentation of care provided and participates in various quality review programs and activities.

This facility is an equal opportunity employer and complies with federal, state and local anti-discrimination laws, regulations and ordinances.

Category: Behavioral

Organization: AdventHealth Shawnee Mission

Schedule: Part-time

Shift: 1 - Day

Travel: AdventHealth Shawnee Mission

Req ID: 21034471

We are an equal opportunity employer and do not tolerate discrimination based on race, color, creed, religion, national origin, sex, marital status, age or disability/handicap with respect to recruitment, selection, placement, promotion, wages, benefits and other terms and conditions of employment.

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