Impactful Part-Time Utilization Review Coordinator

Universal Health Services, Inc.; Pembroke (MA); On-site; USD 34,000 - 48,000; Part time

Benefits offered by this job

Competitive compensation

Generous paid time off

Medical, dental, vision plans

401(k) with company match

SoFi student loan refinancing program

Career development opportunities

Tuition discount with Chamberlin Uni

Student loan repayment

Tuition reimbursement

Job summary

Universal Health Services, Pembroke Hospital in Pembroke, MA, seeks a part-time Utilization Review Coordinator. This role supports daily clinical reviews, payer coordination, and documentation to promote optimal utilization and reimbursement.

You will work 24 hours per week, 8:00 a.m. to 4:30 p.m., three weekdays (Thu and Fri mandatory, with one additional weekday). Licensure in MA and utilization management experience are required or preferred.

Qualifications

• Massachusetts licensure as a RN, LCSW, LICSW, or LMHC is required.
• Experience in Utilization Management with a provider, insurer, or HMO is preferred.
• Experience in a behavioral health setting is preferred.

Responsibilities

• Performs timely, daily clinical reviews with all payer types to secure authorization for continued treatment.
• Educates and guides on level of care requirements and payer expectations for patient acuity.
• Completes quality and timely appeal/denial letters and supports post claim recovery review and audits.
• Coordinates with hospital operations to ensure documentation aligns with patient conditions.
• Contributes to monthly utilization data trends for overall operations.
• Facilitates physician reviews with payers as required.
• Performs other duties as assigned.

Job description

Universal Health Services, Pembroke Hospital in Pembroke, MA, seeks a part-time Utilization Review Coordinator. This role supports daily clinical reviews, payer coordination, and documentation to promote optimal utilization and reimbursement.

You will work 24 hours per week, 8:00 a.m. to 4:30 p.m., three weekdays (Thu and Fri mandatory, with one additional weekday). Licensure in MA and utilization management experience are required or preferred.