You. 

You bring your body, mind, heart and spirit to your work as a Utilization Review Coordinator at West Pines.

You know when to move quickly. When to sit quietly. When to laugh loudly.

You know how to move fast. You know how to stay organized. You know how to have fun.

Youâ™re great at what you do, but you want to be part of something even greater. Because you believe that while individuals can be strong, the right team is invincible.

Us. 

West Pines Behavioral Health at Lutheran Medical Center is part of SCL Health, a faith-based, nonprofit healthcare organization that focuses on person-centered care. Our tight knit team specializes in helping adults ages 18 and older with psychiatric or addiction concerns.

Benefits are one of the ways we encourage health for you and your family. Our generous package includes medical, dental and vision coverage. But health is more than a well-working body: it encompasses body, mind and social well-being. To that end, weâ™ve launched a Healthy Living program to address your holistic health. Healthy Living includes financial incentives, digital tools, tobacco cessation, classes, counseling and paid time off. We also offer financial wellness tools and retirement planning. 

We. 

Together weâ™ll align mission and careers, values and workplace. Weâ™ll encourage joy and take pride in our integrity. 

Weâ™ll laugh at each otherâ™s jokes (even the bad ones). Weâ™ll hello and high five. Weâ™ll celebrate milestones and acknowledge the value of spirituality in healing.

Weâ™re proud of what we know, which includes how much there is to learn. 

Your day.

As a Utilization Review Coordinator you need to know how to:

• Collect in-depth information about a patientâ™s admission information condition, situation and functioning to identify that meet pre cert criteria


• Gather and collect patient information regarding patient admission information, condition and functioning criteria and contact insurance company for pre cert.


• Serves as a liaison between Physicians, hospital, payers and other members of the healthcare team in order to facilitate appropriate patient care in the setting most meeting the patient needs.


• Attends department and other meetings as required


• Assists in monitoring appropriate hospitalization and continued stays.  Acts responsibly on behalf of patient.


• Prepare and maintain confidential records of utilization review functions


• Interface with external healthcare monitoring agencies, providing data as required by the operational contract and/or medical staff policy


• Provide assistance with the reconsideration/appeals process


• Participate in treatment planning conferences to provide information about the hospital, the community, and financial resources


• Recommend, assist and/or prepare reports for display of statistical data

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Your experience.

We hire people, not resumes. But we also expect excellence, which is why we require: 

• Minimum of a Bachelorâ™s degree in social work, counseling or a behavioral health related field or graduate of an accredited school of nursing. 


• Experience in developing and coordinating an organized approach and system for utilization review and management


• Knowledge and experience with Managed Care- preferred 


• Prior direct experience in a behavioral health setting- preferred 

Your next move.

Now that you know more about being a Utilization Review Coordinator on our team we hope youâ™ll join us. At SCL Health youâ™ll reaffirm every day how much you love this work, and why you were called to it in the first place.