Utilization Review (UR) Coordinator

Responsibilities Universal Health Services: One of the nation’s largest and most respected providers of hospital and healthcare services, Universal Health Services, Inc. has built an impressive record of achievement and performance. Growing steadily since its inception into an esteemed Fortune 500 corporation, our annual revenues were $11.4 billion in 2019. In 2020, UHS was again recognized as one of the World’s Most Admired Companies by Fortune; in 2019, ranked
293 on the Fortune 500; and in 2017, listed
275 in Forbes inaugural ranking of America’s Top 500 Public Companies. Headquartered in King of Prussia, PA, UHS has more than 90,000 employees and through its subsidiaries operates 26 acute care hospitals, 328 behavioral health facilities, 42 outpatient facilities and ambulatory care access points, an insurance offering, a physician network and various related services located in 37 U.S. states, Washington, D.C., Puerto Rico and the United Kingdom. Kingwood Pines Hospital: Kingwood Pines Hospital is a 116 bed facility located in the beautiful residential Kingwood community. We are located about 30 miles northeast of the Houston Medical Center. The hospital provides 24-hour emergency services. We serve children, adolescents, and adults for psychiatric and behavioral health. The hospital also has services in intensive outpatient and partial hospital program services. www.kingwoodpines.com Click here for a virtual Facility Tour Qualifications POSITION SUMMARY The Utilization Review (UR) Coordinator will perform admission and continued-stay reviews; position also assists with performing discharge planning to patients. KEY RESPONSIBILITIES Performs reviews for appropriateness of admission and continued stays. Contacts representative soft third-party payers to verify benefit coverage. Obtains coverage for appropriate admission and continued stay relative to patient diagnosis, treatment and progress. Appeals inappropriate reimbursement denials with representatives of third-party payers in light of patient diagnosis, treatment and progress. Demonstrates knowledge of referral sources. Establishes communication with referral sources and outside practitioners to ensure adequate discharge planning. Particpates in unit staffing regularly to expedite discharge planning Documents details and contacts related to discharge planning and appointments in a timely manner. Maintains communication with AHP, physician’s offices and referral sources. Other job duties as assigned EDUCATION Associate degree or equivalent experience in a health care related field. Bachelor’s degree preferred. Knowledge of behavioral health systems and Utilization Management required. EXPERIENCE Minimum of two (2) years professional experience in a health care setting, preferably inpatient. Minimum of two (1) years experience in UR or Case Management. LICENSURE/CERTIFICATION: LPC, LMSW, LVN or RN preferred. Current TX Driver's License Current CPR (can be obtained on-site upon employment) Current HWC & Verbal De-Escalation (can be obtained on-site upon employment) WHAT DO OUR CURRENT STAFF VALUE AT UHS? An environment that puts patient care first. Having the opportunity to grow, learn, and advance in your career. There are very robust continuing education options and opportunities for leadership development with UHS. Supportive and responsive leadership. Competitive salary and comprehensive benefits package. BENEFIT HIGHLIGHTS: Challenging and rewarding work environment Career development opportunities within UHS and its Subsidiaries Competitive Compensation Excellent Medical, Dental, Vision and Prescription Drug Plan 401(K) with company match and discounted stock plan Generous Paid Time Off Free Basic Life Insurance UHS is a registered trademark of UHS of Delaware, Inc., the management company for Universal Health Services, Inc. and a wholly-owned subsidiary of Universal Health Services, Inc. Universal Health Services, Inc. is a holding company and operates through its subsidiaries including its management company, UHS of Delaware, Inc. All healthcare and management operations are conducted by subsidiaries of Universal Health Services, Inc. To the extent any reference to