On-Site Utilization Review & Care Coordination Specialist

JobCubby; Leesburg (VA); On-site; USD 65,000 - 85,000; Full time

Benefits offered by this job

Health insurance after 30 days

Paid Time Off after 90 days

401(k) with company match after 30days

Job summary

North Spring Behavioral Healthcare, a UHS affiliate, seeks a full-time Utilization Review Coordinator to review admissions and ensure documentation meets criteria. This on-site role supports the treatment team and discharge planning.

The position requires 1–3 years of related experience and a Bachelor's degree; a Master’s degree is preferred. The team collaborates with clinical staff, admissions, and insurance providers to secure appropriate care.

Qualifications

• Good verbal and written communication skills are required.
• Ability to rotate shifts and programs as necessary.
• Must maintain confidentiality of patient information.
• Experience working in healthcare settings is valued.

Responsibilities

• Performs clinical reviews over the telephone to evaluate admission, continued stay, and discharge criteria.
• Facilitates discharge planning with treatment team and coordinates continuum of care for the patient with Social Worker.
• Attends treatment team meetings and liaises between insurance companies and the treatment team.
• Notifies Director of Outpatient Services of potential utilization review problems or denials; assists in appeals.
• Monitors documentation in clinical records and reports problematic areas to supervisor.
• Assists admissions with screening patients pre-hospitalization to ensure admission criteria are met.

Skills

Verbal communication

Written communication

Shift flexibility

Confidentiality

Education

Bachelor's degree

Master's degree

Job description

North Spring Behavioral Healthcare, a UHS affiliate, seeks a full-time Utilization Review Coordinator to review admissions and ensure documentation meets criteria. This on-site role supports the treatment team and discharge planning.

The position requires 1–3 years of related experience and a Bachelor's degree; a Master’s degree is preferred. The team collaborates with clinical staff, admissions, and insurance providers to secure appropriate care.