UTILIZATION COORDINATOR - LPN

Company: The Brooklyn Hospital Center
Location: Brooklyn
Posted on: May 28, 2023

Job Description:

UTILIZATION COORDINATOR - LPNSalary: $50,000 - $55,000 - LPN Highly Preferred - Bilingual HelpfulYour ability to analyze, evaluate and effectively communicate your observations is critical to our hospitalYou have a practical knowledge and depth of experience to make consistently fair determinations to ensure appropriate utilization of resources and benefits. Plus, your understanding of the complexities of the process, along with your ability to advocate, educate and counsel others would make you an ideal candidate for this vital role.Your Role:Collaborate with the multi-disciplinary team to manage the day-to-day UR process on a prospective, concurrent, or retrospective basis; increase efficiency in delivering quality health care services, and to ensure that appropriate data is tracked, evaluated, and reported. You will also:* Perform clinical reviews to assess medical necessity in compliance with the hospital's UR plan, third party payers and other regulatory requirements* Coordinate care for the designated patient based on specific clinical criteria, regarding coverage for requested services, contract benefits and alternate resources* Participate in process improvement initiatives, clinical case appeals, discharge planning and disease managementYour Education, Skills and Experience must include:* High School Diploma or GED* Current NYS LPN license preferred* Utilization experience in a hospital setting required* Successful completion of an LPN program from an accredited institution preferred* Minimum of 2 years' experience in a hospital environment* Inter Qual and/or Milliman, or other criteria experience* Knowledge of 3rd party payer reimbursement and screening criteria usage* Strong oral and written communication skills with proficiency in PCs* Excellent organizational, interpersonal, negotiation and influential abilitiesLocated in the heart of vibrant and historic Downtown Brooklyn, TBHC is a clinical affiliate of The Mount Sinai Hospital and an academic affiliate of The Icahn School of Medicine at Mount Sinai. As Brooklyn's first hospital, TBHC is proud to be a part of an incredibly diverse community and is committed to Keeping Brooklyn Healthy.Team members here enjoy a stimulating work setting along with competitive salaries and benefits. To apply, please email your resume to recruiter@tbh.org. We are an equal opportunity employer.PDN-99274009-d66a-471c-a9ce-883d4708820e

Keywords: The Brooklyn Hospital Center, New York , UTILIZATION COORDINATOR - LPN, Healthcare , Brooklyn, New York