Utilization & Care Coordination Specialist

Clive Behavioral; Lancaster (Lancaster County); On-site; USD 65,000 - 90,000; Full time

Benefits offered by this job

Competitive compensation

Comprehensive benefits package

Tuition reimbursement

401(k) with company match

Job summary

Lancaster Behavioral Health Hospital is seeking a Utilization Management Coordinator to perform payer authorization reviews and collaborate with care teams across units. The role emphasizes timely documentation, coordination with social services, and adherence to payer criteria to support patient care and reimbursement.

Ideal candidates have a psych-related Bachelor’s degree (Master’s preferred) and licensure in nursing or social work.

Qualifications

• Bachelor’s degree in psych related field or equivalent combination of education and experience. Masters preferred.
• Registered Nurse or Social Work licensure (e.g., LMSW/LSW/LPC/LMHC, etc.) preferred.
• 1–3 years of Utilization Management experience preferred.

Responsibilities

• Performs timely, daily clinical reviews with all payer types to secure authorization for continued treatment.
• Collaborates with hospital operations to ensure timely documentation aligns with patient conditions.
• Acts as a key team member to educate on level of care requirements and payer expectations for patient acuity.
• Ensures denials are followed up weekly and documentation is detailed.
• Maintains accurate Midas documentation daily to avoid payment issues.

Skills

Utilization Management

Education

Bachelor’s degree in psych related field

Master's degree preferred

Tools

Midas

Job description

Lancaster Behavioral Health Hospital is seeking a Utilization Management Coordinator to perform payer authorization reviews and collaborate with care teams across units. The role emphasizes timely documentation, coordination with social services, and adherence to payer criteria to support patient care and reimbursement.

Ideal candidates have a psych-related Bachelor’s degree (Master’s preferred) and licensure in nursing or social work.