Utilization Review Coordinator

The Utilization Review Coordinator initiates pre-certification calls for private insurance and managed Medicare and Medicaid plans while providing concurrent reviews throughout patient stays. This role involves tracking utilization outcomes, managing insurance appeals, and collaborating with the interdisciplinary treatment team to ensure appropriate care and continued stay requirements. The position serves as a liaison with payors and physicians, coordinates with external agencies, and provides ongoing education to staff on legislative and insurance changes.