Behavioral Health Utilization Management Coordinator

Nhccare; Knoxville (TN); On-site; USD 55,000 - 75,000; Full time

Job summary

Knoxville Center for Behavioral Medicine in Knoxville, TN is seeking an experienced Utilization Management Coordinator to support inpatient and Intensive Outpatient Program services. You will verify benefits, obtain authorizations, and collaborate with clinical teams to ensure appropriate patient care.

The role focuses on utilization management, concurrent reviews, and payer communications, requiring knowledge of insurance requirements and medical necessity criteria.

Qualifications

• Bachelor’s degree in nursing or other clinical degree preferred; high school diploma required.
• Utilization Management experience in a healthcare or behavioral health setting.
• Experience with inpatient behavioral health and/or IOP authorizations preferred.
• Knowledge of insurance benefits, medical necessity criteria, and payer requirements.
• Strong organization, communication, and time-management skills.
• Experience with EHR systems and authorization portals.

Responsibilities

• Verify insurance benefits and obtain authorizations.
• Manage concurrent reviews and payer communication.
• Submit clinical information to support continued treatment.
• Track approvals, review dates, and authorization requirements.
• Assist with denials, peer-to-peer reviews, and follow-up.
• Maintain accurate documentation and compliance standards.

Skills

Utilization Management

Inpatient Behavioral Health

IOP Authorizations

EHR Systems

Education

Bachelor's degree in nursing or clinical degree

High school diploma

Tools

Authorization portals

Job description

Knoxville Center for Behavioral Medicine in Knoxville, TN is seeking an experienced Utilization Management Coordinator to support inpatient and Intensive Outpatient Program services. You will verify benefits, obtain authorizations, and collaborate with clinical teams to ensure appropriate patient care.

The role focuses on utilization management, concurrent reviews, and payer communications, requiring knowledge of insurance requirements and medical necessity criteria.