Utilization Management Coordinator (Remote)

Santa Barbara Cottage Hospital; United States; Remote; USD 35,000 - 55,000; Part time

Job summary

An established industry player in behavioral health is seeking a dedicated Utilization Management Coordinator to join their remote team. This role is crucial in securing authorizations from various payers, ensuring optimal utilization of services, and facilitating maximum reimbursement for care provided. The ideal candidate will bring at least two years of behavioral health experience and a strong understanding of Utilization Management processes. Join a mission-driven organization that is committed to improving access to crisis care and supporting individuals in their recovery journey. If you are passionate about making a difference in the lives of others, this opportunity is for you.

Benefits

Comprehensive Health Insurance

401k Company Match

Generous PTO

Employee Assistance Program

Online Subscription to Headspace

Qualifications

• 2+ years of behavioral health experience required.
• Expertise in Utilization Management and clinical auditing preferred.

Responsibilities

• Secure authorizations from payers for inpatient stays.
• Perform utilization reviews and ensure compliance with regulations.
• Document and communicate results to applicable payer sources.

Skills

Behavioral Health Experience

Utilization Management

Clinical Auditing

Communication Skills

Education

High School Diploma or equivalent

Bachelor's degree in Nursing or related field

Job description

Join to apply for the Utilization Management Coordinator (Remote) role at Connections Health Solutions.

We’re not just behavioral health people—we’re crisis people.

Connections Health Solutions is a leading provider of immediate-access behavioral health crisis care. Our team combines medical and recovery-oriented treatment to stabilize individuals in crisis and connect them to community-based resources for ongoing recovery.

Founded by emergency room psychiatrists Dr. Chris Carson and Dr. Robert Williamson, our model is physician-led and data-driven, drawing upon more than 15 years of crisis care expertise. Recognized by SAMHSA and the National Council for Mental Wellbeing as a national best practice, we’ve delivered invaluable treatment to hundreds of thousands of individuals facing crises. Our commitment remains consistent, to improve access, inspire hope, and provide the right support.

Our values shape our decisions, define our culture, and foster continuous learning and growth. We accept people as they are, creating safe spaces where they feel valued and respected. We inspire hope by walking with people side-by-side, showing them grace and compassion. We act with intention, holding ourselves and each other accountable, and doing the right thing. We work as one team, trusting and supporting each other. We embrace change and innovation, striving to find better ways to fulfill our mission.

We are on a mission to change the face of behavioral health. Help us save lives and make a difference.

Responsibilities

What You'll Do:

• The Utilization Management Coordinator pursues and secures authorizations from any and all payers. Ensures appropriate utilization of services at Connections Health Solutions clinics, observation and inpatient units. Facilitates maximum appropriate payment through support of concurrent review of inpatient care by any payer. Obtains prior authorization for service as required.
• Works with all payers to secure authorization for inpatient stays for all individuals admitted to Inpatient or COE Unit.
• Performs utilization review in accordance with all Payor requirements, State Regulations, and Joint Commission Standards. Ensures all payer utilization management staff receive needed daily information to perform their reviews.
• Obtain authorizations for previously identified procedures where required.
• Reviews medical records and evaluates patient progress towards discharge. Performs continuing review on medical records and identification and need for on-going inpatient services. Obtains necessary medical reports, treatment plans and validates BHMP’s progress notes/evaluations for appropriate justifications of continued stay.
• Documents review information as required by State and Payor regulations. Communicates results to applicable payor sources: including requests to BHMP’s for expedited follow-up to all payer UM staff.
• Complies with regulation changes affecting utilization management. Facilitates educational programs and advises physicians and other departments of regulations affecting utilization management.
• Performs all other duties as assigned.

Qualifications

What You'll Bring:

• High School Diploma or equivalent
• At least 2 years of behavioral health experience
• Expertise in Utilization Management responsibilities, tasks, and functions and/or Clinical auditing experience
• The Company has a mandatory vaccination policy. All successful applicants must be fully vaccinated, including showing proper documentation, or otherwise be exempt pursuant to the Company’s exemption process prior to their start date as a condition of employment.

It would be great if you had:

• Bachelor's degree in Nursing, behavioral health, social work, medical coding, or related field
• Previous clinician (Social Work) experience
• Licensed MSW
• Knowledge of ADHS/DBHS and RBHA Policies and Procedures relative to Utilization Management
• Previous experience obtaining authorization from third parties.

What We Offer:

Full-time only:

• Employees (and their families) are offered comprehensive health insurance, including Medical, Dental, Vision, Accident, Critical Illness, and Hospital Indemnity.
• CHS pays for Basic Life, AD&D, Short and Long-Term Disability.
• Voluntary Life insurance option for employees and their families.
• Health Savings Accounts (with $1,000 to $2,000 employer contribution depending on plan).
• Flexible Spending Accounts (health care and dependent care).
• 401k company match after 6 months (50% of deferrals up to 6% of compensation).
• Generous PTO starting at 160 hours accrued annually and 12 recognized company holidays.

All employees (Pool, Part-time and Full-time):

• Employee Assistance Program to help with confidential emotional support, work life solutions, financial solutions, legal assistance, or online support.
• Online Subscription to Headspace, a digital mindfulness and meditation platform.
• After 90 days, you are auto enrolled in the 401k Plan.

Connections Health Solutions is proud to be a Second Chance employer.

EEO Statement

Connections Health Solutions is an equal opportunity employer. We do not discriminate based on race, color, religion, sex, sexual orientation, gender identity, national origin, age, disability, veteran status, or any other characteristic protected by law. We are committed to creating an inclusive and welcoming environment for all employees and applicants.

Seniority level

• Entry level

Employment type

• Part-time

Job function

• Project Management and Information Technology
• Mental Health Care