Utilization Management Coordinator

Posting Summary

Rutgers, The State University of New Jersey is seeking a Utilization Management Coordinator for the Utilization Management within Rutgers University Behavioral Health Care.

The primary purpose of the Utilization Management Coordinator position is to conduct utilization reviews to ensure that clinical services meet medical necessity and all applicable standards for regulatory funding and accrediting agencies.

Among the key duties of this position are the following:

Reviews admissions, continued stays and discharges to determine if they are consistent with established criteria. Refers to the UR Supervisor, those that require additional expertise. If criteria are not met, notifies the UR Supervisor.

Conducts certification, pre-certification and continuing certification requirements for Medicaid, Medicare and insurance clients.

Effectively communicates outcomes of precertification and concurrent re...