Impactful Utilization Review Coordinator (RN or MSW)

Universal Health Services, Inc.; Hopkinsville (KY); On-site; USD 70,000 - 90,000; Full time

Benefits offered by this job

Challenging and rewarding work environment

Competitive Compensation and Generous Paid Time Off

Excellent Medical, Dental, Vision and Prescription Plans

401(k) with company match

SoFi Student Loan Refinancing Program

Retention Bonus Program

Career development opportunities

Job summary

Universal Health Services, Inc. is seeking a Utilization Review Coordinator at Cumberland Hall Hospital in Hopkinsville, KY. This role involves evaluating and coordinating patient care to ensure medical necessity and compliance with insurance regulations.

The ideal candidate will have a Master’s in Social Work or be a Licensed Registered Nurse, along with two years of psychiatric experience. The position includes competitive compensation and numerous benefits, including health plans and a 401(k) matching program.

Qualifications

• Masters prepared in Social Work or possess a current nursing license in Kentucky.
• Two years of psychiatric experience with knowledge of psychotropic medications.

Responsibilities

• Evaluate and coordinate patient care services for medical necessity.
• Obtain and maintain insurance authorizations and approvals.
• Communicate clinical information and coverage with payers.
• Monitor authorization status to prevent reimbursement denials.
• Coordinate with treatment teams on level-of-care decisions.
• Maintain accurate utilization review and authorization records.
• Assist with denial management and appeals.
• Ensure compliance with payer and hospital requirements.

Skills

Knowledge of psychotropic medications

Coordination with clinical staff

Authorization management

Denial management

Education

Masters prepared in Social Work or Licensed Registered Nurse

Job description

Universal Health Services, Inc. is seeking a Utilization Review Coordinator at Cumberland Hall Hospital in Hopkinsville, KY. This role involves evaluating and coordinating patient care to ensure medical necessity and compliance with insurance regulations.

The ideal candidate will have a Master’s in Social Work or be a Licensed Registered Nurse, along with two years of psychiatric experience. The position includes competitive compensation and numerous benefits, including health plans and a 401(k) matching program.