Utilization Management Coordinator - Mental Health Payer Specialist

Lancaster Behavioral Health Hospital; Lancaster (Lancaster County); On-site; USD 65,000 - 85,000; Full time

Benefits offered by this job

Competitive compensation

Generous paid time off

Medical, dental, vision plans

Tuition reimbursement

401(k) with company match

Job summary

Lancaster Behavioral Health Hospital is seeking a Utilization Management Coordinator to perform daily payer reviews and secure treatment authorizations across managed Medicare, Medicaid, and commercial plans.

The role collaborates with social services, nursing, intake, and operations to ensure timely, accurate documentation and appropriate level of care. Licensure in nursing or social work is preferred, with 1–3 years of UM experience.

Qualifications

• Bachelor’s degree in psychology or related field (or equivalent experience).
• RN or Social Work licensure preferred (LPC/LMHC/LCPC/LMHC/LCSW).
• 1–3 years of utilization management experience preferred.

Responsibilities

• Perform daily clinical reviews with payer types to secure authorization for continued treatment.
• Collaborate with hospital operations to align documentation with patient conditions.
• Educate and guide on level of care requirements and payer expectations for patient acuity.
• Ensure denials are followed up weekly with detailed documentation.
• Maintain up-to-date Midas documentation to ensure payment issues are avoided.

Skills

Utilization Management

Education

Bachelor's degree in psychology or related field

Master’s degree preferred

Tools

Midas

Job description

Lancaster Behavioral Health Hospital is seeking a Utilization Management Coordinator to perform daily payer reviews and secure treatment authorizations across managed Medicare, Medicaid, and commercial plans.

The role collaborates with social services, nursing, intake, and operations to ensure timely, accurate documentation and appropriate level of care. Licensure in nursing or social work is preferred, with 1–3 years of UM experience.