Utilization Review Coordinator

Title: Utilization Review Coordinator

State Role Title: 49172

Hiring Range: Based on experience

Pay Band: 5

Agency: Dept Behavioral Health/Develop

Location: Southern Va Mental Health Inst

Agency Website: https://dbhds.virginia.gov/facilities/svmhi/

Recruitment Type: General Public - G

Job Duties

The Department of Behavioral Health and Developmental services support individuals by promoting recovery, self-determination, and wellness in all aspects of life. DBHDS operates 12 facilities: 8 behavioral health facilities for adults, a training center, a psychiatric facility for children and adolescents, a medical center, and a center for behavioral rehabilitation.

State facilities provide highly structured, intensive services for individuals with mental illness, intellectual disability, or need substance use disorder services. DBHDS is committed to a life of possibilities for all Virginians. This position will work at Southern Virginia Mental Health Institute, a 72-bed Joint Commission accredited State Mental Health Facility, located in Danville, VA.

The incumbent in this position is responsible for the day-to-day operation of the utilization management program at SVMHI, including performing concurrent reviews of admission and continued-stay patients, and other focused areas of review. This position consults with healthcare professionals to assure SVMHI is reimbursed for services when eligible from private or public insurance.

The Utilization Management (UM) Coordinator is responsible for coordinating the Utilization Management (UM) Committee activities including scheduling committee meetings, assembling agendas, recording minutes and distributing minutes on a monthly basis. The Coordinator is responsible for tracking agenda items as open, in progress or complete for the UM Committee.

Minimum Qualifications

Completion of post-secondary course work as a Registered Nurse or social work.

Clinical experience as a Registered Nurse or Social Worker in an acute care, intermediate care or skilled care facility or other combination of related training/experience.

The following knowledge, skills and abilities are required to be successful in this position:

Knowledge of inpatient psychiatric treatment and documentation required, to include interdisciplinary treatment planning, discharge planning, and psychosocial rehabilitation.

Functionally adept at working within the Electronic Heath Record (EHR) system, Millennium.

Ability to communicate effectively (verbally and in writing) with clinicians, administrators, and patients.

Knowledge of utilization management principles, third party reimbursement systems, and associated legal/regulatory requirements.

Intermediate computer skills in typing, Microsoft Word, and Microsoft Excel.

Ability to write policies, procedures, and instructional tools; design forms; and produce memorandum, agendas, and minutes.

Ability to work independently to include organization, prioritization, and maintaining timelines of multiple tasks/projects.

Involvement in promoting the Recovery Principles in the Utilization Review/ Management department and creates opportunities for staff to attend Recovery related training classes. Coaches staff in Recovery Principles.

Additional Considerations

Experience working in an inpatient psychiatric, healthcare facility, acute care, or long-term care setting.

Experience in Utilization Review and compliance with the rules and regulations of the Medicare and Medicaid programs.

Veterans and people with National Service.

Bilingual fluency in Spanish and English.

Special Instructions

You will be provided a confirmation of receipt when your application and/or résumé is submitted successfully. Please refer to "Your Application" in your account to check the status of your application for this position.

Applicants must list all relevant experience that you wish to be considered for this position. Applicants will be provided confirmation of receipt when your application and/or resume is submitted. Please refer to "Your Application" in your account to check the status of your application for this position.

A fingerprint-based criminal history check and reference checks are required for the selected candidate for this position. Under Virginia Code §37.2-314 and 37.2-408.1, the Department of Behavioral Health and Developmental Services is prohibited from employing or using as volunteers, persons who have been convicted of specific "barrier" crimes or persons who may be the subject of pending "barrier" charges.

DBHDS facilities are no longer required to ensure that all staff members are vaccinated against COVID-19. However, facilities encourage and educate staff on the benefits, and continue to offer COVID-19 vaccination programs to staff, residents/clients.

Employees may be required to disclose immunization status for purposes of infection prevention and/or management of outbreaks. Upon acceptance of a job offer, new recruits will be asked to disclose their vaccination status (and for those fully vaccinated, proof of vaccination) during the pre-employment process. If you have any questions, contact the Office of Human Resources.

Commonwealth's Alternate Hiring Process: In support of the Commonwealth's commitment to inclusion, individuals with disabilities are encouraged to apply through the Commonwealth Alternative Hiring Process.

To be considered for this opportunity, applicants will need to provide their Certificate of Disability (COD) provided by a Certified Rehabilitation Counselor with the Department of Aging and Rehabilitative Services (DARS). Veterans are encouraged to answer Veteran status questions and submit their disability documentation, if applicable, to DARS, to get their Certificate of Disability. To obtain a Certificate of Disability go to: https://www.vadars.org/drs/cpid/PWContact.aspx, or call DARS at 800-552-5019. Reasonable accommodations are available to persons with disabilities during the application and/or interview process per the Americans with Disabilities Act. Contact Human Resources at (434) 773-4208 for assistance.

DBHDS is an equal Opportunity Employer. Employment opportunities are open to all regardless of race, sex, color, national origin, religion, sexual orientation, gender identity, age, veteran status, political affiliation, genetics, or disability.

Minorities, Individuals with Disabilities, Veterans, and people with National Service experience are encouraged to apply. EEO/AA/TTY.

SVMHI uses Form I-9 and E-Verify in the verification of eligibility for employment.

SVMHI is a smoke and vape-free facility in all buildings and outside facility grounds.

Contact Information

Name: Human Resources

Phone: 434-773-4208

Email: svmhihr@dbhds.virginia.gov

In support of the Commonwealth's commitment to inclusion, we are encouraging individuals with disabilities to apply through the Commonwealth Alternative Hiring Process.

To be considered for this opportunity, applicants will need to provide their AHP Letter (formerly COD) provided by the Department for Aging & Rehabilitative Services (DARS), or the Department for the Blind & Vision Impaired (DBVI). Service-Connected Veterans are encouraged to answer Veteran status questions and submit their disability documentation, if applicable, to DARS/DBVI to get their AHP Letter. Requesting an AHP Letter can be found at AHP Letter or by calling DARS at 800-552-5019.

Note: Applicants who received a Certificate of Disability from DARS or DBVI dated between April 1, 2022- February 29, 2024, can still use that COD as applicable documentation for the Alternative Hiring Process.