PHP Utilization Review Coordinator

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

Responsibilities

North Spring Behavioral Healthcare is looking for a fulltime Utilization Review Coordinator (on-site) to join our compassionate and dynamic team!

What We Offer:

• Competitive Salary
• Comprehensive Benefits Package:
• Health insurance – Available after just 30 days.
• Paid Time Off – Start earning after 90 days.
• 401(k) with company match – Eligible after 30 days.

The Utilization Review Coordinator assists admissions in screening patients at the pre-hospital level to ensure that admission criteria are met, and when admitted, follows the chart checking that documentation reflects and meets admission, continued stay, and discharge criteria. Interacts and communicates with clinical staff, Business Office, Admissions, Medical Records, third party reviewers and hospital administration to help receive hospital care they need.

Key Responsibilities

• Performs clinical reviews over the telephone. Reviews that entire chart to evaluate the appropriateness of admission, continued stay, discharge criteria and identifies high-risk cases.
• Facilitates discharge planning with treatment team and coordinates continuum of care for the patient with Social Worker. Monitors the effectiveness of patient outcomes.
• Attends treatment team meetings and serves as a liaison and patient advocate between insurance companies and the treatment team.
• Notifies and alerts Director of Outpatient Services of potential utilization review problems or denials; assists in the preparation and implementation of the appeals process.
• Monitor documentation in clinical records and reports problematic areas to appropriate supervisor, Director of Outpatient Services.
• Assists admissions with screening patients on the pre-hospitalization level to ensure admission criteria are met.

North Spring Behavioral Healthcare, a subsidiary of Universal Health Services, Inc. (UHS), is a Department of Behavioral Health and Developmental Services (DBHDS)-licensed, and Joint Commission approved 87-bed Psychiatric Residential Treatment Facility, and a 40-bed Inpatient Acute Psychiatric Hospital. North Spring is situated on 42 acres of scenic greenlands in historic Leesburg, VA, approximately 25 miles northwest of Washington, D.C. We provide therapeutic programs for adolescents in a safe and secure environment that encourages growth and self-responsibility. Universal Health Services, Inc. (UHS) is one of the nation's largest and most respected healthcare management companies, operating through its subsidiaries acute care hospitals, behavioral health facilities and ambulatory centers nationwide. Founded in 1978, UHS subsidiaries now have more than 83,000 employees. The UHS business strategy is to build or purchase healthcare properties in rapidly growing markets and create a strong franchise based on exceptional service and effective cost control.

One of the nation’s largest and most respected providers of hospital and healthcare services, Universal Health Services, Inc. (UHS) has built an impressive record of achievement and performance. Growing steadily since its inception into an esteemed Fortune 500® corporation, annual revenues during 2025 were $17.4 billion. In 2026, UHS was again recognized as one of Fortune World’s Most Admired Companies™ and in 2025, was listed in Forbes ranking of America’s Largest Public Companies. Headquartered in King of Prussia, PA, UHS has approximately 101,500 employees and continues to grow through its subsidiaries. Operating acute care hospitals, behavioral health facilities, outpatient facilities and ambulatory care access points, an insurance offering, a physician network and various related services located in 40 U.S. states, Washington, D.C., Puerto Rico and the United Kingdom. For additional information visit www.uhs.com.

EEO Statement

All UHS subsidiaries are committed to providing an environment of mutual respect where equal employment opportunities are available to all applicants and teammates. UHS subsidiaries are equal opportunity employers and as such, openly support and fully commit to recruitment, selection, placement, promotion and compensation of individuals without regard to race, color, religion, age, sex (including pregnancy, gender identity, and sexual orientation), genetic information, national origin, disability status, protected veteran status or any other characteristic protected by federal, state or local laws.

Qualifications

• Good verbal and written skills; ability to rotate shifts and programs as necessary; ability to maintain confidentiality of patient information.
• Must consistently exhibit mental and emotional ability to understand and perform the essential functions of the job.
• Bachelor's degree in related field required.
• Master’s Degree in related field preferred.
• One to three years of related experience required.
• Prefer experience with children and adolescents in psychiatric facility or rehabilitation program.

Physical Requirements

Must be able to lift and carry up to 50 pounds; 80-90% of the time the incumbent is standing, walking, kneeling, reaching while working with residents. Requires full range of body motion including handling and physical restraint of residents.

Ability to perform CPR and First Aid.