Utilization Review Coordinator — Mental Health Case Management

Lighthouse Care Center of Georgia, LLC; Augusta (GA); Hybrid; USD 52,000 - 76,000; Full time

Benefits offered by this job

Referral Bonus Program

Competitive Compensation

Paid Time Off

Medical, Dental, Vision and Rx Plans

401(K) with company match

SoFi Student Loan Refinancing Program

Career development opportunities

Pet Insurance

More information on Benefits Website

Job summary

Lighthouse Care Center of Augusta is seeking a dedicated Utilization Review Coordinator to join our case management team. The role focuses on clinical data review to determine eligibility for pre-certification and continued stay reviews, with close collaboration among physicians, nurses, and therapists.

Under the UR Manager, you will ensure timely, compliant, and cost-effective treatment coordination, working within GA licensure rules and with MS4/Midas systems.

Qualifications

• Masters degree in social science fields (social work, counseling, sociology, psychology).
• Two years of psychiatric health care experience and utilization review preferred.
• Must be license-eligible or licensed in Georgia (LAPC, LPC, LMSW, LCSW, LMFT, LMHC).

Responsibilities

• Review clinical content of medical records and coordinate with treatment team and physicians to gather data for insurers.
• Enter pre-certifications and continued stay reviews into Midas and MS4, and verify insurance coverage at the start of the month.
• Coordinate follow-ups with the treatment team and ensure timely communication with insurance entities for authorization.

Skills

Clinical documentation

Communication skills

Team collaboration

Education

Masters level education in social science field

Tools

Midas

MS4

Job description

Lighthouse Care Center of Augusta is seeking a dedicated Utilization Review Coordinator to join our case management team. The role focuses on clinical data review to determine eligibility for pre-certification and continued stay reviews, with close collaboration among physicians, nurses, and therapists.

Under the UR Manager, you will ensure timely, compliant, and cost-effective treatment coordination, working within GA licensure rules and with MS4/Midas systems.