Utilization Review Coordinator

Deer Hollow is the leading mental health center in the country, providing deeply caring, comprehensive treatment to individuals struggling with the devastating impacts and overwhelming challenges of trauma. Deer Hollow’s Trauma Program, we are on the cutting edge of treatment, as everything being done has a very clinically specific intent to assist the client's deepest healing. The clinical team believes the research stating that, statistically, at the root of most issues and behaviors, there is unprocessed trauma and emotional wounding. This unresolved material causes a host of problems, and unlike many programs, Deer Hollow focuses on these wounds and the emotions associated, rather than just the behaviors and symptoms that the clients present with. We provide residential and outpatient programs where our staff oversees and support our clients in a safe environment.

Deer Hollow specializes in First Responder and Professional Wellness. Our clinical team has extensive experience assisting first responders, nurses, teachers, and medical personnel with PTSD, anxiety, cumulative stress, behavioral addictions, and substance abuse. We understand how to apply the most effective and comprehensive treatments and therapies to help these individuals heal the invisible wounds brought on by the trauma of their profession.

We looking for an SUDC/SSW to join our clincial team as a utilization coordinator

Job Summary
We are seeking a highly motivated and detail-oriented Utilization Review Coordinator to join our dynamic team. In this vital role, you will the review of patient care services to ensure they meet established medical necessity criteria, regulatory standards, and organizational policies. This position offers an exciting opportunity to contribute to clinical quality improvement initiatives while working closely with multidisciplinary teams across residential, outpatient, and telehealth programs. The ideal candidate will bring a strong background in utilization management, medical documentation review, and medical criteria for specific levels of care.

Responsibilities

• Conduct comprehensive utilization reviews for inpatient and outpatient services for behavioral health
• Review medical records, clinical documentation to validate medical necessity and appropriateness of care.
• Collaborate with medical providers, case managers, and other healthcare professionals to facilitate discharge planning, case management, and documentation improvement efforts.
• Utilize electricon medical recoreds to access electronic health records efficiently and accurately document findings.

Skills

• Extensive experience with EMR
• Strong knowledge of managed care processes
• Familiarity with health regulation policies such as HIPAA and state healthcare regulations governing medical records management.
• Excellent analytical skills for documentation review and clinical data analysis; ability to interpret behavioral health medical records
• Strong communication skills for collaborating across multidisciplinary teams in residneital and outpatient behavioral health settings
• Experience in a behavioral health setting.

Job Type: Full-time

Pay: $60,000.00 - $80,000.00 per year

Benefits:

• 401(k)
• Health insurance
• Paid time off

Work Location: In person