[Hiring] RN Coordinator - Utilization Review Acute Rehab @American Addiction Centers

Role Description

• Identifies clinical, financial, and psychosocial needs of patients/families and provides leadership and guidance to the multidisciplinary team to develop an individualized plan of care.
• Ensures essential information and necessary forms are placed in the revenue cycle tool and available for the revenue cycle team and other disciplines.
• Provides necessary documentation and information to third party administrators as needed.
• Performs admission and concurrent reviews.
• Applies clinical guidelines during Admission and Concurrent reviews and identifies potential third-party denials. Works with multidisciplinary team to identify and implement alternative plans of care.
• Initiates and requests authorizations for post-acute care as needed to facilitate care coordination.
• Refers pertinent cases to the Medical Director, Service Director, and/or Physician Advisor in a timely manner.
• Collaborates as needed with the physician to plan and implement medical and multidisciplinary plan(s) of care, utilizing clinical pathways when appropriate and available.
• Identifies and escalates barriers and problems to the multidisciplinary team and leadership for intervention and resolution.
• Develops and maintains accurate case records of assigned cases. Documents in the patient's medical record according to department and facility standards.

Qualifications

• Graduation from an accredited School of Nursing required.
• Bachelor's degree in nursing preferred.
• Applicable state RN licensure required.
• Related experience preferred.
• Basic Life Support (BLS) for Healthcare Provider (HCP) per facility requirements.

Requirements

• Works in an office setting, extensive walking throughout the facility.
• Prolonged periods of sitting reviewing medical records and documentation.
• Repetitive wrist motion and occasional lifting of 10-20 pounds.
• Requires frequent verbal and written communication in English.
• Intact sight and hearing with or without assistive devices are required.

Benefits

• Paid Time Off programs.
• Health and welfare benefits such as medical, dental, vision, life, and Short- and Long-Term Disability.
• Flexible Spending Accounts for eligible health care and dependent care expenses.
• Family benefits such as adoption assistance and paid parental leave.
• Defined contribution retirement plans with employer match and other financial wellness programs.
• Educational Assistance Program.