Utilization Review Coordinator — Behavioral Health Advocate

Universal Health Services; Rose Valley (PA); On-site; USD 65,000 - 90,000; Full time

Job summary

The Horsham Clinic, part of Universal Health Services, is seeking a dynamic Utilization Review Coordinator to evaluate medical records and determine the appropriate level of care for patients. This role requires collaboration with clinical teams and a focus on efficient, compliant patient care across our multi-site operations.

The UR Coordinator will liaison with insurance providers, advocate for appropriate length of stay, and oversee UR activities to ensure proper reimbursement.

Qualifications

• Exposure to psychiatric patients who may exhibit violent/ aggressive behavior.
• Must be willing to work with kids and adolescents.
• Master's Level Education/ MSW
• RN License in the state of Pennsylvania
• Licensure in LSW/ LSCW
• Demonstrates working knowledge of behavioral mental health, nursing clinical practices, and management
• Experience in interviewing patients and families in order to obtain clinical information and acute symptoms
• Highly Developed written and verbal communication skills
• 3 or more years of experience in behavioral health setting
• Ability to plan, direct, and monitor others activities with demonstrated leadership abilities that contribute to a positive work environment.
• Proficiency with common computer based applications such as electronic mail, word processing and various databases

Responsibilities

• UR Coordinator evaluates medical records to determine severity of illness and level of care.
• UR Specialist serves as liaison for patients and hospital with insurance companies.
• UR Specialist negotiates length of stay and level of care with insurers.
• Oversees UR activities with other departments to ensure reimbursement for services.

Skills

Communication

Interviews

Leadership

Computer skills

Education

MSW

RN license PA

LSW/LSCW licensure

Tools

Electronic health records

Word processing

Databases

Job description

The Horsham Clinic, part of Universal Health Services, is seeking a dynamic Utilization Review Coordinator to evaluate medical records and determine the appropriate level of care for patients. This role requires collaboration with clinical teams and a focus on efficient, compliant patient care across our multi-site operations.

The UR Coordinator will liaison with insurance providers, advocate for appropriate length of stay, and oversee UR activities to ensure proper reimbursement.