Coordinator – Utilization Management

Full Time - UM Coordinator

Knoxville Center for Behavioral Medicine - a comprehensive inpatient behavioral health facility.

Our center will provide acute behavioral health care and outpatient treatment to adults and geriatric adults who are in crisis from severe symptoms related to behavioral health and/or substance use disorder.

GENERAL DESCRIPTION: Provide administrative support to the Utilization department.

MINIMUM EDUCATION/EXPERIENCE/SKILLS:


* Bachelor's degree in nursing or Other Clinical degree preferred, High school diploma required with 2 years of experience in the Behavioral Health Field.

ESSENTIAL FUNCTIONS: Are determined by the facility and may include, but are not limited to the following:


* Perform pre-certification and negotiate continued stay with third party payors in a professional manner.


* Gather data to support case management activities, including presentation of gathered data and case notes.


* Present knowledge of cases and address the needs of third-party payors in a timely manner, either by verbal or written communication.


* Assist in admissions review, concurrent reviews and discharge planning as determined appropriate by UM director.


* Assist physician in peer review by serving as information resource, gathering data to support review and schedule peer review.


* Keep leadership advised of status of current person(s) receiving services, regarding utilization activities through timely documentation and participation in performance improvement activities.

OTHER FUNCTIONS:


* Performs other functions and tasks as assigned.