Utilization Management Coordinator (FT)
Job Posting for Utilization Management Coordinator (FT) at River Edge Behavioral Health
Utilization Management Coordinator.
About River Edge Behavioral Health.
Serving more than 10,000 Georgians, River Edge continues to be one of the state's leading resources for mental health, substance use disorder treatments, and support as well as individuals with intellectual and developmental disabilities. The full continuum of River Edge Behavioral Health services provides state-of-the-art treatment and support services for more than 13,000 children, youth, families, and adults annually, who experience mental illness, addiction, co-occurring disorders, or developmental disabilities.
This position requires a person who is passionate and motivated to ensure client records have the appropriate authorizations and clinical information necessary for Behavioral Health services in order to "make life better" for the clients we serve.
Duties & Responsibilities:
Duties & Responsibilities:
- Create Connects batch files.
- Retrieve and process response files from Beacon's SFTP site.
- Work Connects documents are rejected, denied, held, no CID, multi-final payer, and status appropriately.
- Review discharge connects and flip to UM complete.
- Manage and process BHL CSU authorizations and update CoreLogic.
- Review and process the AC file for BHL CSU authorization.
- Complete the State Discharge process for Fulton locations.
- Create PTRF referral via Beacon authorization request.
- Review and process Connect documents in UM review.
- Run Service delivery, service history, service history (staff credential), ADA group, and failed claims reports.
- Manage Carelogic client discharge process.
- Review each client record discharge request and create discharge connects, and discharge summaries.
Minimum Training & Experience:
- COVID Vaccinated.
- High School Diploma (Bachelor in helping professions such as social work, community counseling, counseling psychology, or criminology preferred).
- 1-3 years of utilization management experience.
- Attention to detail and ability to work well under pressure.
- Must effectively manage time.
All selected applicants must pass a satisfactory background/motor vehicle clearance and pre-employment drug test.
Due to the volume of applications received, we are unable to provide information on application status by phone or e-mail. All qualified applicants will be considered; however, only those selected for an interview will be contacted by the hiring managers. Applicants who are not selected will receive a notification via email. This position is subject to close at any time once a satisfactory applicant pool has been identified.
We at River Edge believe every employee has a right to a safe work environment. Therefore, we require full vaccination of all employees. Getting the vaccine, frequently washing your hands, sanitizing common areas, and wearing your mask continue to be the most effective way to fight COVID-19.
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Salary.com Estimation for Utilization Management Coordinator (FT) in Macon, GA
$125,279 to $173,397
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