Attention current TriHealth employees:
Please apply for this position by submitting an online internal application via SuccessFactors. Please be certain to update your SuccessFactors Employee Profile prior to applying to this position.
INTAKE/UTILIZATION COORDINATOR-PSYCHIATRY: This position performs an initial screening for psychiatric patients. The Intake staff reviews the clinical data with the ED physician to determine the level of care needed. This may include inpatient admission, transfer, or discharge. Intake also assists with in-house psychiatric consults, community referrals and assists in maintaining expedient flow of ED patients to the psychiatry units. This position performs utilization management functions on a prospective, concurrent or retrospective basis in order to maximize revenue for Trihealth. This includes analysis of clinical information presented with comparison to established national clinical criteria to determine appropriate place of service such as inpatient/outpatient/observation and medical necessity for ongoing inpatient care. In addition, understands all government and health plan requirements while negotiating with health plan to obtain authorization for services or payment on denied claims. This staff works independently with a high level of autonomy and decision making surrounding high dollar services and revenue.
EDUCATION: Associate's Degree or Diploma in Nursing Registered Nurse RN (Nursing)
EXPERIENCE: 4-5 years Clinical Psychiatric Nursing or Psychiatric Social Worker; Substance Abuse experience 1-2 years Substance Abuse
SPECIALIZED KNOWLEDGE: Working knowledge of insurance verification and processes and adult and geriatric psychiatry..
Job Title: INTAKE/UTILIZATION COORDINATOR-PSYCHIATRY
Department Name: GSH DEPT OF PSYCHIATRY
Location: Good Samaritan Hospital
Employment Status: Optional Position
Shift: Day/Evening Shift
Weekend Commitment: Yes
Holiday Commitment: Yes
On-Call Commitment: No