Behavioral Health Utilization Management Specialist

Universal Health Services; Chicago (IL); On-site; USD 70,000 - 90,000; Full time

Job summary

Hartgrove Behavioral Health System in Chicago is seeking an Utilization Management Coordinator to support timely medical reviews and secure authorization for inpatient and outpatient care. You will work within a multidisciplinary team to ensure appropriate utilization and patient acuity alignment with care guidelines.

Responsibilities include data entry in the Midas system, communicating with payers and providers within tight timelines, and participating in quality assurance activities to

Qualifications

• Bachelor’s degree in behavioral health required; Master’s preferred.
• Experience in utilization management is preferred (1+ year).
• Knowledge of insurance, managed care and regulatory guidelines.

Responsibilities

• Perform timely daily clinical reviews to secure authorizations for continued treatment.
• Enter data in Midas system and ensure accuracy and timeliness.
• Educate and guide on level of care requirements within the multidisciplinary team.
• Communicate findings to attending providers within 24 hours of identification of issues.
• Coordinate with managed care reviewers for clinical updates and payor reviews.
• Participate in hospital-wide quality assurance and utilization management meetings.

Skills

Utilization management

Interdisciplinary teamwork

Communication skills

Education

Bachelor’s Degree in behavioral health related field

Master’s Degree preferred

Tools

Midas system

Job description

Hartgrove Behavioral Health System in Chicago is seeking an Utilization Management Coordinator to support timely medical reviews and secure authorization for inpatient and outpatient care. You will work within a multidisciplinary team to ensure appropriate utilization and patient acuity alignment with care guidelines.

Responsibilities include data entry in the Midas system, communicating with payers and providers within tight timelines, and participating in quality assurance activities to