Behavioral Health Utilization & Care Coordinator

River Edge; Macon (GA); On-site; USD 42,000 - 66,000; Full time

Benefits offered by this job

Flexible spending accounts

11 Paid holidays

Voluntary Life Insurance

Job summary

River Edge Behavioral Health in Macon, GA is seeking an Utilization Management Coordinator to ensure appropriate behavioral health care levels while meeting medical necessity, authorization, and documentation requirements. The role blends utilization review, care coordination, and authorization management within behavioral health services.

Located at 3575 Fulton Mill Road, Macon, GA, the position offers a path to contribute to discharge planning, authorizations, and UM processes, with a

Qualifications

• High School Diploma; Bachelor's in helping profession preferred.
• 1–3 years of utilization management experience.

Responsibilities

• Create Connects batch files for processing.
• Retrieve and process response files from Beacon’s SFTP site.
• Process Connects documents in states such as rejected, denied, hold, no CID, multi-finalpayer and status appropriately.
• Review discharge connects and flip to UM complete.
• Manage and update CareLogic with BHL CSU authorizations.
• Review and process AC files for BHL CSU authorization.
• Complete State Discharge process for Fulton locations.
• Create PTRF referrals via Beacon authorization requests.
• Review and process Connects documents in UM review.

Skills

Utilization management

Care coordination

Documentation

Education

High School Diploma

Bachelor's degree in helping profession

Job description

River Edge Behavioral Health in Macon, GA is seeking an Utilization Management Coordinator to ensure appropriate behavioral health care levels while meeting medical necessity, authorization, and documentation requirements. The role blends utilization review, care coordination, and authorization management within behavioral health services.

Located at 3575 Fulton Mill Road, Macon, GA, the position offers a path to contribute to discharge planning, authorizations, and UM processes, with a