UM Coordinator, Behavioral Health Utilization Review

Universal Hospital Services Inc.; Memphis (TN); On-site; USD 65,000 - 90,000; Full time

Benefits offered by this job

Tuition assistance

Paid time off

Health benefits

401k match

Student loan refinancing

Pet insurance

Job summary

Lakeside Behavioral Health System is seeking an UM Coordinator to evaluate patient records, determine level of care, and coordinate with insurers. The role requires clinical knowledge of psychiatric conditions and utilization review processes.

The position reports to the Utilization Management department and involves coordination with physicians and hospital staff to optimize patient care and reimbursement outcomes.

Qualifications

• Master's degree in healthcare field (Nursing, Counseling, Psychology or Social Work)
• Registered Nurse (RN) licensure preferred
• 3–5 years direct psychiatric patient care experience
• Knowledge of psychiatric care, utilization review, and DSM‑V; strong insurance reimbursement understanding
• Advanced computer skills; strong analytical, organizational, verbal and written skills

Responsibilities

• Evaluate patient medical records to determine illness severity and appropriate level of care.
• Serve as liaison for patients and insurance companies; negotiate and advocate for LOS and level of care.
• Oversee utilization review activities to ensure reimbursement for services.
• Facilitate physician weekly staffing meetings and coordinate billing with outpatient offices.

Skills

Psychiatric care

Utilization review

Analytical skills

Verbal communication

Written communication

Insurance reimbursement

DSM-V

Advanced computer skills

Education

Master's degree in healthcare field

Registered Nurse (RN)

Tools

EHR systems

Job description

Lakeside Behavioral Health System is seeking an UM Coordinator to evaluate patient records, determine level of care, and coordinate with insurers. The role requires clinical knowledge of psychiatric conditions and utilization review processes.

The position reports to the Utilization Management department and involves coordination with physicians and hospital staff to optimize patient care and reimbursement outcomes.