UR COORDINATOR (RN OR MSW)

Cumberland Hall Hospital; Hopkinsville (KY); On-site; USD 60,000 - 80,000; Full time

Benefits offered by this job

Competitive Compensation

Generous Paid Time Off

Excellent Medical, Dental, Vision Plans

401(k) with company match

Career development opportunities

Job summary

Cumberland Hall Hospital in Hopkinsville, KY, is seeking a Utilization Review Coordinator to evaluate and coordinate patient care services. This role is critical in ensuring compliance with insurance policies while maintaining quality patient care.

The ideal candidate will hold a master's degree in social work or be a licensed RN with at least two years of psychiatric experience. The position offers competitive compensation and generous benefits, including medical, dental, and a 401(k) with company match.

Qualifications

• Minimum two years psychiatric experience with knowledge of psychotropic medications.
• Current nursing license to practice in Kentucky or master’s degree in social work.

Responsibilities

• Evaluate and coordinate patient care services to ensure medical necessity.
• Obtain and maintain insurance authorizations and approvals.
• Communicate with payers regarding clinical information.
• Assist with denial management, appeals, and peer reviews.

Skills

Psychiatric knowledge

Insurance authorization

Communication

Utilization review

Education

Masters in Social Work or Registered Nurse

Job description

Responsibilities

Utilization Review Coordinator Opportunity

Cumberland Hall Hospital is a 97 bed, licensed, acute psychiatric hospital located in beautiful Hopkinsville, KY. Cumberland Hall features individual units for youth, adults and active‑duty military, and offers inpatient acute care, partial hospitalization, and intensive outpatient programs. On average, over 1500 patients receive care from our compassionate health care team each year at Cumberland Hall Hospital.

Website: https://cumberlandhallhospital.com/

The Utilization Review Coordinator is responsible for evaluating and coordinating patient care services to ensure medical necessity, appropriate level of care, and compliance with insurance and regulatory requirements. This role works closely with clinical staff, physicians, and insurance providers to obtain authorizations, support reimbursement, minimize denials, and promote efficient utilization of hospital resources while maintaining quality patient care.

Job Duties to include:

• Review admissions and continued stays for medical necessity.
• Obtain and maintain insurance authorizations and approvals.
• Communicate with payers regarding clinical information and coverage.
• Monitor authorization status and help prevent reimbursement denials.
• Coordinate with treatment teams on level-of-care decisions.
• Maintain accurate utilization review and authorization records.
• Assist with denial management, appeals, and peer reviews.
• Ensure compliance with payer, regulatory, and hospital requirements.

Benefits for staff include:

• Challenging and rewarding work environment
• Competitive Compensation and Generous Paid Time Off
• Excellent Medical, Dental, Vision and Prescription Drug Plans
• 401(k) with company match and discounted stock plan
• SoFi Student Loan Refinancing Program
• Retention Bonus Program
• Career development opportunities within UHS and its 300+ Subsidiaries!
• More information is available on our Benefits Guest Website: benefits.uhsguest.com

Qualifications

• Education: Masters prepared in Social Work or Licensed Registered Nurse
• Experience: Two years psychiatric experience with knowledge of psychotropic medications.
• Licenses/Certificates: Current nursing license to practice in Kentucky or master’s degree in social work

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.