Utilization Review Coordinator - Part Time, 24 Hours/Week

Universal Hospital Services Inc.; Pembroke (MA); On-site; USD 48,000 - 56,000; Part time

Benefits offered by this job

Competitive compensation

401(k) with company match

Tuition discount program

Student loan repayment

Job summary

Universal Health Services, Pembroke Hospital is seeking a part-time Utilization Review Coordinator to support daily clinical reviews and payer decisions. The role requires Massachusetts licensure (RN/LCSW/LICSW/LMHC) and UM experience, with a preference for behavioral health background.

The position involves coordinating with the multidisciplinary team, ensuring timely documentation, and contributing to utilization data trends. Flexibility to work three weekdays, 8am–4:30pm, is required.

Qualifications

• Licensure to practice in Massachusetts is required.
• Experience in Utilization Management is required or preferred.
• Behavioral health experience is preferred but not required.

Responsibilities

• Performs daily clinical reviews across payer types to obtain authorization for continued treatment based on payer criteria.
• Educates and guides the treatment team on level of care, payer expectations, and patient acuity.
• Completes timely appeal/denial letters and supports post-claim recovery and audits.
• Coordinates with social services, business office, intake, and nursing to align documentation with patient conditions.
• Contributes to monthly utilization data trends using hospital data tools for overall operation.
• Facilitates physician reviews with payers as required.
• Performs other duties as assigned.

Skills

Utilization Management

Interdisciplinary teamwork

Regulatory compliance

Education

Massachusetts licensure (RN/LCSW/LICSW/LMHC)

Job description

Responsibilities

Utilization Review Coordinator Opportunity -

This is a part time position, working 24 hours per week. Working hours are 8am - 4:30pm, 3 weekdays per week. The schedule will require working every Thursday and Friday with the flexibility to select the third weekday in your schedule.

Pembroke Hospital is a 120-bed acute care, inpatient behavioral health facility located south of Boston, in Pembroke, MA. Situated on 26 acres, we offer inpatient and partial hospitalization treatment to teens, adults and older adults, and our services are designed to assess, stabilize, and treat patients by addressing their primary symptoms and problems. At Pembroke Hospital, all positions begin and end with caring for the Patient. By Listening Deeply and Understanding the Story of our Patients, we will Make a Difference in the Lives we Touch.

The Utilization Review Coordinator facilitates a continuum of service while promoting positive outcome and optimal reimbursement, through coordination of patient care, daily clinical reviews, quality documentation, appeals, and reporting.

Benefit Highlights

• 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
• SoFi Student Loan Refinancing Program
• Career development opportunities within UHS and its 300+ Subsidiaries!
• Further your education at a low cost through our Tuition Discount partnership with Chamberlin University
• Student Loan Repayment - $200 per month
• Tuition Reimbursement - $5,000 per year

Responsibilities

• Performs timely, daily clinical reviews with all payer types (Managed Medicare, Managed Medicaid and commercial) to secure authorization for continued treatment (i.e. by fax, telephone or on-line) based on payer’s criteria.
• Functions as a key member of the multidisciplinary treatment team to educate and guide on level of care requirements and payer expectations for patient acuity and appropriate utilization.
• Completes quality and timely appeal/denial letters. Participates in post claim recovery review and ongoing audit activity, supporting compliance with CMS and other regulators.
• Works collectively with hospital operations (social services, business office, Intake, Nursing) to ensure timely documentation is aligned with patient conditions.
• Contributes to monthly utilization data trends using hospital data tools to report for the overall operation.
• Facilitates physician reviews with payers as required.
• Performs other duties as assigned/required by this position.

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 its inception into an esteemed Fortune 500 corporation, annual revenues during 2025 were $17.4 billion. In 2026, UHS was again recognized as one of Fortune World’s Most Admired Companies and in 2025, was listed in Forbes ranking of America’s Largest Public Companies.

Headquartered in King of Prussia, PA, UHS has approximately 101,500 employees and continues to grow through its subsidiaries. Operating acute care hospitals, behavioral health facilities, outpatient facilities and ambulatory care access points, an insurance offering, a physician network and various related services located in 40 U.S. states, Washington, D.C., Puerto Rico and the United Kingdom. For additional information visit www.uhs.com.

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Qualifications

Requirements

• Licensure: Current Massachusetts licensure as a RN, LCSW, LICSW, or LMHC
• Experience in Utilization Management either with a provider, insurance or HMO organization.
• Experience in a behavioral health setting is 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.