Utilization Review Coordinator

Welcome to Del Amo Hospital, a 166 bed private psychiatric hospital that is located in warm Southern California, near the beautiful beaches in the South Bay area of Los Angeles. Del Amo Hospital has distinguished itself through a wide range of programs that are individually tailored to each patients particular needs, such as crisis stabilization, trauma-based disorders, borderline personality disorder, PTSD, dissociative disorders (DID), eating disorders - including anorexia, bulimia and compulsive overeating, dual diagnosis, sexual addiction, detox, and mental illness.
Del Amo Hospital now has an immediate opening for a Full Time Utilization Review Coordinator. The Utilization Review Coordinator manages activities in the process of evaluating the use of professional medical care, services, procedures and facilities using pre-established criteria; performs admission and concurrent review of all patients using pre-established criteria. Interfaces with other departments, mental health professionals and external review agencies; appeals adverse decisions by external review agencies.
Job responsibilities include but not limited to:
Monitors admission and concurrent reviews of all patients, both internally and externally, as outlined in the Utilization Review Plan.Functions as hospital intermediary with external review agencies.Ensures that appropriate parties are notified in the event of an admission, or continuing stay denial.Manages utilization review data and information flow.Collaborates with hospital personnel and medical staff to ensure optimal patient care.
Del Amo Hospital provides a full spectrum of quality mental health care that includes: assessments and referrals, crisis intervention, child, adolescent and adult services, as well as specialty programs that include trauma, sexual recovery and eating disorders.
Del Amo Hospital is owned, managed and operated by a subsidiary of Universal Health Services, Inc., one of the largest providers of high-quality healthcare in the nation.
Full-time positions are benefited positions. Benefits include Medical, Dental, Vision, Life, LTD, AD&D and Flexible Spending Accounts, as well as 401k and Stock plans. Paid Time Off and Extended Leave accrues on day one and is available for use at the completion of 90 days.
REQUIREMENTS
Significant experience as a Registered Nurse or Nurse Manager in a psychiatric setting. Must be thoroughly conversant with the principles of Utilization Review and Quality Assurance.