Utilization Management Coordinator

Lancaster, PA; Lancaster, Northern (Lancaster County, KY); Hybrid; USD 55,000 - 75,000; Full time

Job summary

Lancaster Behavioral Health Hospital is seeking an Utilization Management Coordinator to perform daily clinical reviews across payer types to secure authorization for continued treatment. You will work with social services, business office, intake, and nursing to ensure timely documentation matches patient conditions.

The role requires 1–3 years of Utilization Management experience, with a Bachelor’s in psychology-related field; Master’s preferred and licensure in RN or social work is preferred.

Qualifications

• Bachelor’s degree in psych related field or equivalent combination of education and experience.
• Masters preferred.
• RN or Social Work licensure (i.e. LCSW, LMHC, LPC) preferred.

Responsibilities

• Performs timely clinical reviews with all payer types to secure authorization.
• Collaborates with hospital operations to align documentation with patient conditions.
• Educates and guides on level of care requirements and payer expectations.
• Ensures denials are followed up weekly with detailed documentation.
• Maintains accurate Midas documentation daily.

Skills

Utilization management

Communication

Team collaboration

Education

Bachelor’s degree in psych related field

Master’s degree preferred

Equivalent education/experience considered

Job description

Responsibilities

Lancaster Behavioral Health Hospital (LBHH) is a 126-bed, inpatient psychiatric hospital and joint venture between Lancaster General Health/Penn Medicine and Universal Health Services.

In addition to a general adult unit and dedicated adolescent unit, the facility offers services for treating those with co-occurring disorders on the psychiatric-medical unit, an intensive adult unit to care for those with severe conditions, as well as a women’s trauma unit.

The Utilization Management Coordinator is responsible for completing the following duties and tasks:

• Performs timely, daily clinical reviews with all payer types (Managed Medicare, Managed Medicaid and commercial) to secure authorization for continued treatment (i.e. by fax, telephone or on-line) based on payer’s criteria.
• Works collectively with hospital operations (social services, business office, Intake, Nursing) to ensure timely documentation is aligned with patient conditions.
• Functions as a key member of the multidisciplinary treatment team to educate and guide on level of care requirements and payer expectations for patient acuity and appropriate utilization.
• Ensure that all denials are followed up weekly and documentation is detailed.
• Assures that Midas documentation is updated daily and appropriately. That all documentation has enough detail to ensure no issues with payment.

What do our current employees value at LBHH?

• An environment that puts patient care first.
• One of the most rewarding aspects of working at LBHH is providing excellent care, comfort, and security to the patients and families you treat, at their most vulnerable times.
• Having the opportunity to grow, learn, and advance in your career.
• There are very robust continuing education options and opportunities for leadership development.
• Supportive and responsive leadership.
• Competitive salary and comprehensive benefits package.

What’s in it for me?

• Challenging and rewarding work environment
• Competitive Compensation & Generous Paid Time Off
• Excellent Medical, Dental, Vision and Prescription Drug Plans
• Robust tuition reimbursement
• 401(K) with company match and discounted stock plan
• SoFi Student Loan Refinancing Program
• Career development opportunities within UHS and its 300+ Subsidiaries!
• An opportunity to make a difference every single day

Qualifications

What Does LBHH Require for this Role?

Education: Bachelor’s degree in psych related field and/or equivalent combination of education and experience. Masters preferred.

Licensure: Registered Nurse or Social Work, Marriage and Family, Mental Health Counseling (i.e. LPC, LMHC, LCSW, LCPC, LPCC) preferred.

Experience: 1 to 3 years of Utilization Management preferred.

Lancaster Behavioral Health Hospital: Treatment. Compassion. Hope. Today, tomorrow and always.

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.

We believe that diversity and inclusion among our teammates is critical to our success.

Authorized by

Corporate Human Resources