UR COORDINATOR

This role coordinates utilization review activities for continuum services at Brentwood Hospital. The coordinator performs initial, concurrent, and extended stay reviews, interprets managed care and government payer policies, and supports appropriate referrals to the Business Office and/or physician.

• Conduct initial reviews and monitor appropriateness & need for referral to Business Office and/or physician
• Conduct concurrent and extended stay reviews
• Gather information from the patient record and seek information from the treatment team
• Interpret managed care, Medicare, and Medicaid policies for the treatment team
• Proactively monitor utilization of continuum services to optimize reimbursement for the facility

The position focuses on utilization review operations in a behavioral health setting, using managed care, Medicare, and Medicaid policy interpretation to guide review decisions and reimbursement optimization. Work centers on extracting relevant information from the patient record and partnering with the treatment team.

The ideal candidate is a Utilization Review Coordinator who can perform initial, concurrent, and extended stay reviews and proactively monitor utilization of continuum services to support appropriate referrals and optimize reimbursement. They can interpret managed care, Medicare, and Medicaid policies and serve as a resource to the treatment team using information gathered from the patient record.