Utilization Review; UR​/Utilization; UM Coordinator

Responsibilities

The Utilization Review / Utilization Management (UR/UM) Coordinator (Licensed Therapist or RN) works with Utilization Review/Management, Intake, Business Office, Medical Records, Clinical Staff, Nursing, and providers to coordinate and communicate patient information to insurance companies for the assignment of benefits.

Responsibilities include:

• Performs clinical reviews over the telephone and electronically.
• Utilizes ASAM criteria (DSM-V) to determine appropriateness of admission, continued stay, discharge criteria, and identify high-risk cases.
• Adheres to accrediting and regulatory agency requirements in maintaining records to ensure compliance.

Qualifications

• L icensure through state composite board for nursing or counseling/therapy:
• Minimum RN, LMSW, LAPC, LAMFT
• Preferred BSN, MSN, LCSW, LPC, LMFT
• Three (3) years of experience in chart analysis, utilization review, medical/clinical terminology, and acuity of illness
• Knowledge and understanding of a variety of insurances including Traditional Medicare, Medicare Advantage Plans, and Commercial Plans
• Knowledge and experience with chemical dependency programs, mental health programs, situational evaluations, and crisis intervention, preferred.

What We Offer

• CEUs required for biannual licensure for Therapists (provided free)
• Rewarding work environment
• Growth and development opportunities within UHS and its 300+ subsidiaries
• Excellent medical, dental, vision and prescription drug plan
• 401k plan with company match and discounted stock plan
• SoFi Student Loan Refinancing Program

Apply online at

About Universal Health Services

Universal Health Services, Inc. (NYSE: UHS) is a leading provider of hospital and healthcare services. UHS operates acute care hospitals, behavioral health facilities, outpatient facilities and more across the U.S., Regions, and U.K.

EEO Statement

All UHS subsidiaries are committed to providing an environment of mutual respect with equal employment opportunities for all applicants and teammates. UHS subsidiaries are equal opportunity employers and support recruitment, selection, placement, promotion and compensation without regard to race, color, religion, age, sex (including pregnancy, gender identity, and sexual orientation), genetic information, national origin, disability status, protected veteran status, or any other characteristic protected by law.