Utilization Review Coordinator

Socket.dev; Augusta (GA); On-site; USD 65,000 - 85,000; Full time

Benefits offered by this job

Referral Bonus Program

Competitive Compensation

Excellent Medical, Dental, Vision

401(K) with company match

Career development opportunities

Job summary

Lighthouse Care Center of Augusta is seeking a dedicated Utilization Review Coordinator to join our Case Management team in Augusta, GA. The role centers on coordinating clinical content to ensure high-quality, cost-effective treatment aligned with regulatory requirements.

Under UR Manager guidance, you will conduct clinical reviews to determine eligibility for pre-certification and continued stay decisions, collaborating with physicians and staff to gather necessary data for insurance

Qualifications

• Masters level education in social science field (social work, counseling, sociology, psychology)
• Must be license-eligible or licensed in Georgia (LAPC, LPC, LMSW, LCSW, LMFT, LMHC)
• Must have 2 years of experience in a psychiatric health care setting, delivery of care to psychiatric and/or chemically dependent patients and utilization review
• Nurses with a current GA or Multistate license encouraged to apply (LPN, RN)

Responsibilities

• Review clinical content of medical records, participate in treatment team meetings, and collaborate with physicians, therapist, nurses and pertinent staff on gathering the necessary data to communicate with insurance companies/authorizing entities to ensure initial precertification and continued authorization is achieved.
• Ensure input of pre-certifications and continued stay reviews into Midas, follow-up on unfinished pre-certifications from the day before, coordinate with the treatment team on any follow-ups necessary, verify insurance coverage at the first of the month, and post patient payments into MS4.
• Trained in all aspects relative to timely gathering of clinical criteria, communication of clinical criteria, and entry of supporting clinical criteria into computer based systems, in addition to other job duties.

Education

Masters degree in social science

License-eligible or licensed in Georgia (LAPC, LPC, LMSW, LCSW, LMFT, LMHC)

2 years experience in psychiatric health care setting and utilization review

Nurses with GA license encouraged (LPN, RN)

Tools

Midas

MS4

Job description

Responsibilities

Lighthouse Care Center of Augusta is seeking a dedicated, compassionate Utilization Review Coordinator to add to our growing team.

Lighthouse Care Center of Augusta has been providing psychiatric services to the CSRA for more than 15-years. Located in Augusta, GA our 84-bed facility provides a therapeutic setting for those seeking treatment for mental illness. Lighthouse Care Center offers unique and individualized programming for adolescents and adults that sets us apart from many other treatment facilities, and our tenured team includes seasoned medical staff.

Website: https://www.LighthouseCareCenters.com

The Utilization Review Clinician opportunity is a key member of the Lighthouse Case Management team who will integrate and coordinate clinical content with a keen focus on patient care; ensuring that delivery of high-quality and cost-effective treatment is consistent with the mission, vision, and values of Universal Health Services and in accordance with government regulation, licensing and accreditation requirements. Under the direction of the UR Manager, the Utilization Review Coordinator is responsible for conducting clinical review of data to determine eligibility respective to pre-certification and continued stay reviews.

Job Duties/ Responsibilities:

• Review clinical content of medical records, participate in treatment team meetings, and collaborate with physicians, therapist, nurses and pertinent staff on gathering the necessary data to communicate with insurance companies/authorizing entities to ensure initial precertification and continued authorization is achieved.
• Ensure input of pre-certifications and continued stay reviews into Midas, follow-up on unfinished pre-certifications from the day before, coordinate with the treatment team on any follow-ups necessary, verify insurance coverage at the first of the month, and post patient payments into MS4.
• Trained in all aspects relative to timely gathering of clinical criteria, communication of clinical criteria, and entry of supporting clinical criteria into computer based systems, in addition to other job duties.

Benefit Highlights:

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

About Universal Health Services:

One of the nation’s largest and most respected providers of hospital and healthcare services, Universal Health Services, Inc. (UHS) has built an impressive record of achievement and performance. Growing steadily since itsinceptioninto an esteemed Fortune500corporation, annualrevenues during2025were$17.4billion.In 2026,UHS was again recognized as one of FortuneWorld’s Most Admired Companies™ and in 2025, waslisted in Forbes ranking of America’s Largest Public Companies. Headquarteredin King of Prussia, PA, UHS has approximately101,500employeesand continues to grow through its subsidiaries. Operating acute care hospitals, behavioral health facilities, outpatient facilities and ambulatory care access points, an insurance offering, a physiciannetworkand various related serviceslocatedin 40U.S.states, Washington, D.C., PuertoRicoand the United Kingdom. Foradditionalinformationvisitwww.uhs.com.

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Qualifications

Education and Experience:

• Masters level education in social science field (social work, counseling, sociology, psychology)
• Must be license-eligible or licensed in Georgia. (LAPC, LPC, LMSW, LCSW, LMFT, LMHC)
• Must have 2 years of experience in a psychiatric health care setting, delivery of care to psychiatric and/or chemically dependent patients and utilization review
• Nurses with a current GA or Multistate license encouraged to apply. (LPN, RN)

Certifications, License, Registration:

LMHC, LMFT, LAPC, LPC, LMSW, LCSW, LPN or RN preferred

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.