Utilization Review Coordinator

The Utilization Review Coordinator performs a variety of duties to ensure the best possible utilization of clinical/behavioral healthcare resources related to the delivery of substance use disorder treatment.

Essential Duties and Responsibilities Facilitates communications between facility intake, billing, and clinical department as related to obtaining and maintaining client funding for clinical services.Prepares and facilitates client pre-certification enrollments, continued stay, transition of care, and discharge reviews in a timely manner.Maintains case files in prescribed manner.Completes admission, continued stay and discharge ASAMs for residents admitted to the facility during work hours.Acts as the point of contact with MCO and SCA agencies on matters related to obtaining funding and continuation of funding for clients.Assists counseling staff with identifying client discharge options to include continuing care placement, outpatient services, and other community-based services.Updates and maintains an on-going database of referral agencies and discharge referral sources and the appropriate contacts within those agencies.Acts as the facility liaison in resolving any funding issues that may arise with the MCO/SCA or DOC and maintain detailed records of any communications between the facility and funding agency (e.g.

documents when, where and to whom ASAM forms are sent, records receipt of funding authorizations, etc.Coordinates data entry in the WITS and funder-specific systems.Complies with all H.I.PA.A.

and confidentiality requirements.Performs other duties as assigned.