Utilization Management Coordinator – Pre-Arrival

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🌪️ Oklahoma – Remote

🌪️ Oklahoma – Remote

⏱ Part Time

🟡 Mid-level

🟠 Senior

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Saint Francis Health System

WebsiteLinkedInAll Job Openings

10,000+ employees

Founded 1960

🏥 Healthcare

🏨 Hospitality

🤝 Non-profit

Healthcare • Hospitality • Non-profit

Saint Francis Health System is a healthcare organization based in Tulsa, Oklahoma that operates multiple hospitals, clinics, specialty centers, and support services across eastern Oklahoma. It offers a broad range of clinical services including primary care, cardiology and heart & vascular services, cancer care, neurosciences, behavioral and mental health, orthopedic care, women’s and pediatric care, imaging & lab services, rehabilitation, hospice and home care, trauma services, and specialty institutes (e. g. , Heart and Vascular Institute, Trauma Institute, Children’s Hospital). The system provides urgent care, virtual urgent care, in-home urgent care via DispatchHealth, emergency care including a pediatric emergency center, and many outpatient clinics and diagnostic services. It also supports physician services, medical education (OSU residency partnership), community outreach, financial assistance, patient billing/price transparency, charitable giving, and volunteer programs. The organization lists locations, patient resources, MyChart patient portal, and administrative functions (careers, supplier info, privacy and compliance notices).

📋 Description

• Provide administrative and clinical support throughout patient reviews, placement in levels of care, receipt of necessary services, and discharge planning • Participate in treatment teams and communicate reimbursement issues to providers • Participate in the Patient Care Committee and Utilization Review Staff Committee • Provide data and contribute to internal process improvement • Provide staff education as needed • Meet review intervals and supply clinical information for authorization • Respond to requests for additional clinical detail • Provide eligibility, benefits, and level-of-care information to treatment teams and committees • Seek treatment information for service authorization reviews • Contribute to discharge planning and quality-of-care process improvement • Identify and report quality improvement triggers • Review patient eligibility and benefits and match level-of-care utilization • Ensure compliance with managed care behavioral health standards and documentation requirements • Investigate and prepare insurance appeals related to medical necessity or treatment issues • Participate in ongoing utilization management and utilization review process improvement

🎯 Requirements

• Behavioral health, inpatient psychiatric, or utilization management experience preferred • Completed the basic professional curricula of a school of nursing approved and verified by a state board of nursing, with a diploma or degree, or a Master's degree in Social Work, Counseling, or a related behavioral health field • Valid multistate or State of Oklahoma Registered Nurse License, or LCSW, LPC, or LMFT license • 3–4 years of related experience in behavioral health care, some of which may be in behavioral health managed care • Working knowledge of Microsoft Word, Excel, and Access • Effective interpersonal, written, and oral communication skills • Ability to analyze data to discover facts or develop knowledge, concepts, or interpretations • Ability to organize and prioritize work effectively and efficiently • Detail orientation when examining numerical data • Ability to synthesize clinical case data into concise summaries • Availability for Monday–Friday, 8:00 a.m.–4:30 p.m. schedule

🏖️ Benefits

• Limited benefit offerings • Virtual Office arrangement