Care Utilization & Payer Liaison (Behavioral Health)

Hartgrove Behavioral Health System; Chicago (IL); On-site; USD 65,000 - 85,000; Full time

Benefits offered by this job

Competitive wages

Shift differentials

Career advancement

Job summary

Hartgrove Behavioral Health System in Chicago, IL is seeking a full-time Utilization Management Coordinator to ensure timely authorization for inpatient and outpatient services across payer types. You will collaborate with the multidisciplinary team and support data collection for CMS compliance.

The role emphasizes timely documentation, data integrity in the Midas system, and participation in hospital-wide quality programs, while supporting a patient-centered, evidence-based level of care

Qualifications

• Bachelor’s Degree in behavioral health field required; Master’s degree preferred.
• LCPC, LCSW, LPC, LSW, LMFT, RN or CADC preferred.
• 1+ year experience in Utilization Management preferred.

Responsibilities

• Performs timely, daily clinical reviews to secure authorization for continued treatment across payer types.
• Enters all relevant data in the Midas system including certifications, denials, Medicare and appeals.
• Educates and guides on level of care requirements and payer expectations within the multidisciplinary team.
• Communicates with attending provider and other disciplines within 24 hours of issues related to criteria, discharge planning, or documentation.
• Coordinates with managed care reviewers for clinical updates within 24 hours of certification.
• Performs other duties as assigned and participates in quality and committee activities.

Skills

Utilization management

Data entry accuracy

Communication skills

Multidisciplinary teamwork

Problem solving

Education

Bachelor's degree in behavioral health

Master's degree preferred

Tools

Midas system

Job description

Hartgrove Behavioral Health System in Chicago, IL is seeking a full-time Utilization Management Coordinator to ensure timely authorization for inpatient and outpatient services across payer types. You will collaborate with the multidisciplinary team and support data collection for CMS compliance.

The role emphasizes timely documentation, data integrity in the Midas system, and participation in hospital-wide quality programs, while supporting a patient-centered, evidence-based level of care