Job Summary: The Utilization Review Quality Assurance Coordinator is responsible for all compliance related paperwork and ensures paperwork is completed in a

…specialist regarding correct level of care and reimbursement. Apply knowledge of utilization review , discharge planning, patient status changes, length of stay,

…develops, coordinates, and implements with the direction and approval of the Utilization Review Committee and Senior Administration the processes, procedures,

…Federal or State regulations pertaining to their practice. + Have an understanding of Utilization Review to progress plan of care. + Understand how

…Minimum of three (3) years experience specifically in Behavioral Health Utilization review and casemanagement.Managed Care or Discharge Planning experience

…efficiency of the use of health care services, procedures, and facilities for utilization review and /or /evacuation/repatriation. Work as a liaison between the

…payroll. + Develop and implement crisis intervention emergency procedures, oversee Utilization Review , Quality Assurance, investigations, internal evaluations. +

…community. + Ensure day-to-day processes are conducted in accordance with the Utilization Review Accreditation Commission (URAC) and other regulatory standards.

…maintain quality control policies for equipment, participate in quality assurance and utilization review programs. And apply radiation protection principles to

…high levels of patient satisfaction. The RN Care Coordinator consistently conducts the utilization review process and the discharge planning process as required