Behavioral Health Utilization Coordinator (Day Shift)

Hartgrove Hospital; Chicago, Northern (IL, KY); Hybrid; USD 65,000 - 85,000; Full time

Benefits offered by this job

Competitive wages

Shift differentials

Career advancement

Patient safety focus

Job summary

Hartgrove Behavioral Health System is seeking an Utilization Management Coordinator to perform timely clinical reviews and coordinate authorization across payer types. The role collaborates with a multidisciplinary team to ensure appropriate level of care and alignment with payer criteria.

The position requires a Bachelor’s in behavioral health, with Master’s preferred, and experience in utilization management.

Qualifications

• Bachelor’s Degree in behavioral health related field required; Master Degree preferred.
• LCPC, LCSW, LPC, LSW, LMFT, RN or CADC preferred.
• 1+ year of Utilization Management experience preferred.
• Knowledge of utilization review, insurance and managed care procedures.
• Effective oral and written communication skills to support patient advocacy and payer negotiations.

Responsibilities

• Performs timely daily clinical reviews to secure authorization for continued treatment across payer types.
• Enters data in Midas system including certifications, denials and appeals.
• Educates and guides on level of care requirements and payer expectations.
• Communicates with attending providers and other disciplines within 24 hours of issues.
• Interacts with managed care reviewers and facilitates peer reviews with payers as required.
• Maintains all records/data pertaining to the Utilization Management Program.

Skills

Utilization Management

Communication

Healthcare policy

Education

Bachelor's Degree in behavioral health related field

Master Degree preferred

Licenses: LCPC, LCSW, LPC, LSW, LMFT, RN or CADC preferred

Tools

Midas system

Job description

Hartgrove Behavioral Health System is seeking an Utilization Management Coordinator to perform timely clinical reviews and coordinate authorization across payer types. The role collaborates with a multidisciplinary team to ensure appropriate level of care and alignment with payer criteria.

The position requires a Bachelor’s in behavioral health, with Master’s preferred, and experience in utilization management.