Utilization Review & Compliance Coordinator - Windwood Family Svcs

Location of Job (city): 


Perform utilization management activities for 12-17 bed psychiatric residential program (PRTF).Acts as hub for all clinical information and services provided; develops interdisciplinary comprehensive treatment plan including long-term goals for each child according to DHEC and Medicaid standards. Works with Medical Director to direct services provided by the multidisciplinary team in order to achieve positive outcomes and permanency whenever possible. Negotiates continued stay with insurers when medical necessity is present. Provides groups and specialized individual sessions. Completes documentation according to contract and agency standards.

Job Responsibilities: 

Treatment Plan Development and Oversight: Manages client admissions. Utilizes information gathered from interviews and past client records Develop Treatment plans and monitor team’s compliance of treatment plan goals; coordinate treatment plan meetings with agency medical director, families, and referring agencies; Actively participates in interdisciplinary meetings in order to get a realistic picture of progress from each department; determine course of action. Sets schedule for transition visits; conducts home visits prior to transition beginning and post discharge from program. Works with client and families to establish post discharge services. Establishes and maintains professional relationships with outside agencies. Creates addendum to treatment plans as necessary. Ensures service interventions match treatment plan goals, behavior plans, and develops strategies that will enhance child’s probability of success. Monitors child’s progress in the school setting, during therapeutic recreation activities, during outside play, and in their living quarters.

Job Reports To: 

Executive Director

Job Qualifications: 

Licensed Independent Professional preferred (LPC, LISW-CP)

Must be able to work independently. Must be comfortable negotiating for continued stay according to DHHS/DHEC mandates. Must be able to provide constructive criticism for staff documentation

Submit Resumes To (Name): 

Debbie McKelvey

Submit Resumes To (Email): 


Employment Status (part-time, full-time, etc.): 

Deadline to Apply: 

Monday, 20 August 2018