Behavioral Health Utilization Review Coordinator

Universal Health Services, Inc.; Las Vegas (NV); On-site; USD 30,000 - 43,000; Full time

Benefits offered by this job

Competitive pay

Paid time off

Medical, dental, vision coverage

Job summary

Spring Mountain Treatment Center, part of Universal Health Services, Inc. (UHS), is seeking a full-time Utilization Review Coordinator to monitor service utilization and optimize reimbursement.

The role liaises between managed care organizations and clinical staff, conducts reviews for certification requirements, and supports admissions with pre-certifications. The position emphasizes data gathering on utilization, length of stay, and quality metrics, plus training staff on documentation and

Qualifications

• Bachelor's degree in a related healthcare field is required; Masters preferred.

Responsibilities

• Act as liaison between managed care organizations and clinical staff.
• Review insurance plans for reimbursement requirements.
• Monitor length of stay and inform staff of issues affecting stay.
• Gather and report utilization, discharge data and quality metrics.
• Conduct reviews for medical necessity and services.
• Facilitate peer review calls with external organizations.
• Initiate and complete the appeals process for denials.
• Assist admissions with pre-certifications of care.
• Provide ongoing staff training on documentation and criteria.

Skills

Utilization Review

Authorizations

Leadership

Communication

Education

Bachelor's degree in Nursing, Social Work, Psychology, Health Information Management or related healthcare field

Job description

Spring Mountain Treatment Center, part of Universal Health Services, Inc. (UHS), is seeking a full-time Utilization Review Coordinator to monitor service utilization and optimize reimbursement.

The role liaises between managed care organizations and clinical staff, conducts reviews for certification requirements, and supports admissions with pre-certifications. The position emphasizes data gathering on utilization, length of stay, and quality metrics, plus training staff on documentation and