Utilization Review Coordinator

Universal Health Services; South Attleboro (MA); On-site; USD 70,000 - 90,000; Full time

Benefits offered by this job

Student Loan Repayment

Tuition Reimbursement

Paid Time Off - 26 days/year + roll‑o

Excellent Medical, Dental, Vision

401(K) with company match

Job summary

Universal Health Services' Fuller Hospital in South Attleboro, MA seeks a full-time Utilization Review Coordinator to ensure appropriate admissions and continued care, interfacing with payers, agencies, and the medical team. The role emphasizes patient advocacy and adherence to hospital policies.

Required MA licensure as RN, LCSW, LICSW, or LMHC and at least 1 year in utilization management or related field, with solid documentation and analytical skills.

Qualifications

• Massachusetts licensure as RN, LCSW, LICSW, or LMHC is required.
• 1+ year of experience in utilization management, insurance, or HMO organizations.
• Ability to assess data and apply age-specific care needs and growth/development principles.

Responsibilities

• Thoroughly reviews patient medical records to determine admission necessity.
• Monitors continued stay appropriateness across hospital programs.
• Documents criteria and reviews findings per policy and procedures.
• Performs other duties as assigned by the position.

Skills

Utilization management

Patient advocacy

Education

RN licensure (MA)

LCSW/LICSW licensure (MA)

LMHC licensure (MA)

Job description

Utilization Review Coordinator Opportunity -

Fuller Hospital is a 109-bed licensed, private psychiatric facility located in South Attleboro, Massachusetts providing inpatient and outpatient behavioral health services to residents of Massachusetts and Rhode Island. Inpatient units are designed to treat adults with general psychiatric or intellectual disabilities, as well as adolescents with general psychiatric issues. Patients with co-occurring psychiatric and substance abuse disorders can be treated on most units. Fuller Hospital also provides a less intensive Partial Hospitalization Program (PHP) to patients with psychiatric and co-occurring psychiatric and substance abuse disorders.

The Utilization Review Coordinator is responsible for monitoring the effective and efficient use of health care resources by review of patient admission and continued stay appropriateness in all programs of the hospital. They interact with outside agencies, third party payers, and managed care companies in accordance with contractual agreements, acting as a patient advocate and a representative of the hospital. This is a full time, 40 hour per week position.

Responsibilities

• Thoroughly reviews the patient’s medical record, assesses the medical necessity for all admissions based on DSM-IV and hospital criteria
• Reviews the patient’s treatment through the course of hospitalization to ensure appropriateness of care
• Documents criteria and reviews findings according to established policy, procedure, and protocols
• Performs other duties as assigned/required by this position

Benefit Highlights

• Student Loan Repayment - $200 per month
• Tuition Reimbursement - $5,000 per year
• Challenging and rewarding work environment
• Competitive Compensation & Generous Paid Time Off (26 days per year + roll over)
• Excellent Medical, Dental, Vision and Prescription Drug Plans
• 401(K) with company match and discounted stock plan
• SoFi Student Loan Refinancing Program
• Career development opportunities within UHS and its 300+ Subsidiaries!
• Supervision for Licensure
• More information is available on our Benefits Guest Website: benefits.uhsguest.com

About Universal Health Services

Headquartered in King of Prussia, PA, Universal Health Services, Inc. (NYSE: UHS) is one of the nation’s largest and most respected providers of hospital and healthcare services. Since our founding in 1979, UHS has grown steadily into a premier Fortune 500® corporation perennially recognized by multiple esteemed national rating entities. Through its subsidiaries, UHS operates inpatient acute care facilities, inpatient behavioral health facilities, outpatient and other facilities, nationwide virtual behavioral health services, an insurance offering, a physician network and various related services with physical locations in the U.S., Puerto Rico, Ireland and United Kingdom. www.uhs.com.

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Qualifications

Requirements

• Licensure: Current Massachusetts licensure as a RN, LCSW, LICSW, or LMHC
• Experience: One (1) or more years of experience in utilization management, insurance, and/or HMO organization
• Knowledge: Must be able to demonstrate knowledge and skills necessary to provide interventions appropriate to the age of the patients with whom they interact; Demonstrate knowledge of the principles of growth and development over the lifespan, possess the ability to assess data reflective of the patient’s status, and interpret the appropriate information needed to identify each patient’s requirements relative to their age specific needs.

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.

At UHS and all our subsidiaries, our Human Resources departments and recruiters are here to help prospective candidates by matching skill set and experience with the best possible career path at UHS and our subsidiaries. During the recruitment process, no recruiter or employee will request financial or personal information (e.g., Social Security Number, credit card or bank information, etc.) from you via email. Our recruiters will not email you from a public webmail client like Hotmail, Gmail, Yahoo Mail, etc.