Behavioral Health Utilization Review Lead

UHS Physician Careers; Ambler (Montgomery County); On-site; USD 70,000 - 95,000; Full time

Benefits offered by this job

Competitive benefits after 30 days

401(k)

Tuition reimbursement

Paid time off

Job summary

The Horsham Clinic in Ambler, PA is seeking an Utilization Review Coordinator to evaluate medical records and determine the appropriate level of care for patients. You will liaise with insurance providers and coordinate with hospital departments to optimize reimbursement and patient care.

Ideal candidates have a Master’s in Social Work or RN/LSW licensure, strong interviewing and communication skills, and at least three years in behavioral health.

Qualifications

• Master's degree in social work or related clinical field.
• RN license in Pennsylvania is required.
• LSW/LSCW licensure preferred or required.

Responsibilities

• Evaluate medical records to determine severity and level of care.
• Serve as liaison for patients and hospital with insurance companies.
• Negotiate and advocate for patient length of stay and level of care.
• Oversee utilization review activities to ensure reimbursement.

Skills

Interviewing patients

Communication

Leadership

Behavioral health knowledge

Education

Master's Degree in Social Work (MSW)

RN license (PA)

LSW/LSCW licensure

Job description

The Horsham Clinic in Ambler, PA is seeking an Utilization Review Coordinator to evaluate medical records and determine the appropriate level of care for patients. You will liaise with insurance providers and coordinate with hospital departments to optimize reimbursement and patient care.

Ideal candidates have a Master’s in Social Work or RN/LSW licensure, strong interviewing and communication skills, and at least three years in behavioral health.