Viewing: Utilization Reviewer Coordinator

Utilization Reviewer Coordinator

Job: 168220

Location: Fort Lauderdale, FL

Facility: FL Broward Cty Reg Office

Type: Full-Time

Shift: Day 8 hour

Recruiter: Regina Delemos

Email: RDelemos@Wellpath.us

Department (Org): Regional Office

You Matter

• Make a difference every day in the lives of the underserved
• Join a mission driven organization with a people first culture
• Excellent career growth opportunities


Join us and find a career that supports:
• Caring for overlooked, underserved, and vulnerable patients
• Diversity, equity, inclusion, and belonging
• Autonomy in a warm team environment
• Growth and training

 

Perks and Benefits
In addition to comprehensive benefits including medical, dental, vision, paid time off, and 401k, we foster a work, life balance for team members and their family to support physical, mental, and financial wellbeing including:
• DailyPay, receive your money as you earn it!
• Tuition Assistance and dependent Scholarships
• Employee Assistance Program (EAP) including free counseling and health coaching
• Company paid life insurance
• Tax free Health Spending Accounts (HSA)
• Wellness program featuring fitness memberships and product discounts
• Preferred banking partnership and discounted rates for home and auto loans

 

*Eligibility for perks and benefits varies based on employee type and length of service. 

Why Us

Now is your moment to make a difference in the lives of the underserved.
If there is one unifying characteristic of everyone on our team, it is the deep desire to make a difference by helping society's most vulnerable and often overlooked individuals. Every day we have the distinct honor and responsibility to show up with non-judgmental compassion to provide hope and healing to those who need it most. For those whose calling it is to serve others, now is your moment to join our mission to provide quality care to every patient with compassion, collaboration, and innovation, to live our mantra to “Always Do The Right Thing!”, and to collectively do our part to heal the world, one patient at a time.

 

Wellpath sees hundreds of thousands of unique individuals in their facilities month over month and a very large percent of those individuals receive direct clinical care, which includes lives saved by Narcan. 

 

We offer ongoing training and development opportunities for licensed and unlicensed healthcare team members, and have best in class clinical resources for training, education, and point of care support.

How you make a difference

The Utilization Review Coordinator will perform admission and continued-stay reviews.  This position also assists with performing discharge planning to patients.

Key Responsibilities

  • Review precertification requests for medical necessity and collaborate with medical providers for additional clinical information as needed.
  • Establish rapport with colleagues, support staff, patients, families, and physicians, demonstrating strong teamwork and relationship management skills.
  • Utilize coordination of services, patient advocacy, and resource management to enhance service quality, promote cost-effective outcomes, and prevent unnecessary re-hospitalization.
  • Provide counsel and in-service training on utilization management practices as applicable.
  • Identify alternative resources, address issues with referrals and providers promptly, and demonstrate effective decision-making in case management.

Qualifications & Requirements

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 two (2) years of professional experience in a health care setting, preferably inpatient preferred.
  • Minimum one (1) year clinical or utilization review or case management preferred.
  • Knowledge of managed care regulations required.

Licenses/Certifications

  • LPC, LMSW or RN or other healthcare related licensure preferred

We are an Equal Employment Opportunity/Affirmative Action Employer

We celebrate diversity and are committed to creating an inclusive environment for all employees.
check mark Apply for this job now

We encourage you to apply!

If you are excited about a role but your experience doesn’t seem to align perfectly with every element of the job description, we encourage you to apply. You may be just the right candidate for this, or one of our many other roles.


We encourage you to apply!

If you are excited about a role but your experience doesn’t seem to align perfectly with every element of the job description, we encourage you to apply. You may be just the right candidate for this, or one of our many other roles.