Peace - RN Utilization Review, Psych, PRN - UofL Health
Louisville, KY 40205
About the Job
We are Hiring RN Utilization Review Coordinators!
Location: Peace Hospital - 2020 Newburg Rd. Louisville KY
Shift: PRN
Responsibilities:About Us
Peace Hospital, part of UofL Health, is a private, non-profit behavioral health hospital. One of the largest behavioral health facilities in the nation, Peace Hospital is known for providing care for children, adolescents, adults and senior adults, age 55 and older. Our Kosair for Kids Children’s Peace Center is the largest and most comprehensive private provider of youth inpatient behavioral health services in the country treating children and adolescents with behavioral health and co-occurring disorders. We have a partial hospitalization program for school-aged children and an inpatient specialty program for children and adolescents who have complex treatment needs, such as intellectual or developmental disabilities accompanied by acute behavioral and psychiatric symptoms. UofL Health is home to over 14,000 team members, 1000+ providers, 200+ practice locations, 9 hospitals, and 4 medical centers.
Our Mission
As an academic health care system, we will transform the health of the communities we serve through compassionate, innovative, patient-centered care.
Job Summary
The Utilization Review coordinator performs activities which support the Utilization Management functions. They are responsible for the delivery of the Utilization Management process including but not limited to: making clinical recommendations regarding medical necessity for admission and continues stay, screens patients for client specific guidelines regarding insurance, Medicare and/or Medicaid guidelines, send payor specific Notice of Admission and continued stay reviews. The employee communicates with physician and case managers regarding payor approval/denial of admission and continues stay review. They process payor denials and retro reviews, promote optimal health care outcomes in accordance with the policies, procedures, applicable laws and contracts, philosophy, mission, and values of UofL Health, assumes responsibility and accountability for the appropriate utilization of facilities and services and serves as a resource to physicians. The employee conducts admission and concurrent reviews including observation and inpatients, identifies patients who do not meet criteria and takes action to ensure patients are cared for in the most appropriate level of care; coordinates care in conjunction with other members of the interdisciplinary healthcare team to provide and facilitate optimal health and financial accountability. This employee utilizes effective decision-making; maintains confidentiality of information; actively supports organizational goals and objectives by providing needed information to divisions and departments.
Benefits & Perks
- Competitive Pay & Benefits Options
- Paid Vacation, Sick days, and Holidays
- Free tuition to UofL for Part- and Full-time employees for Child/Spouse/Domestic
- Partner401K with Employer Match
- Opportunities for Advancement
Qualifications:
Job Requirements
- Bachelor of Science in Nursing (required)
- An RN with a bachelor’s degree in Business, Health Care Administration or equivalent on the condition that they enroll in a BSN program within one year of employment and complete the BSN within three years of employment OR Master’s Degree in Social Work, Counseling Psychology, Clinical Psychology, Family and Marriage Therapy, Mental Health Counseling, Health Administration, or other related fields
- Three (3) years of clinical hospital experience
Preferred Experience
- Active Kentucky Registered Nurse License or compact license with privileges to work in Kentucky (preferred) Or Current Licensed Clinical Social Worker (LCSW), Licensed Professional Clinical Counselor (LPCC), Licensed Marriage and Family Therapist (LMFT) or Licensed Psychological Associate (LPA) in the state of Kentucky (preferred)
- Additional (1) year experience in case management/utilization management (preferred)
- Three years’ experience with Behavior Health experience (preferred)
