Utilization Review Coordinator - Part Time, 24 Hours/Week

Pembroke Hospital; Pembroke (MA); On-site; USD 39,000 - 55,000; Part time

Benefits offered by this job

Competitive compensation & PTO

Medical, dental, vision plans

401(k) with company match

SoFi student loan refinancing program

Tuition reimbursement & discount with

Job summary

Pembroke Hospital is seeking a part-time Utilization Review Coordinator to support daily clinical reviews and authorization processes. The role features a 24-hour work week with hours 8am–4:30pm on three weekdays, plus every Thursday and Friday, in Pembroke, MA.

Join a patient-centered team dedicated to care coordination and optimal reimbursement. Candidates must hold Massachusetts licensure (RN, LCSW, LICSW, or LMHC) and have prior utilization management experience, preferably in behavioral

Qualifications

• Experience in Utilization Management or equivalent
• Behavioral health setting experience preferred
• Active Massachusetts licensure as RN, LCSW, LICSW, or LMHC

Responsibilities

• Performs timely clinical reviews with payer types to secure authorization for continued treatment.
• Educates and guides on level of care requirements and payer expectations for patient acuity and utilization.
• Completes appeals/denials letters and supports post claim recovery review and audits.
• Coordinates with hospital operations to ensure timely documentation aligned with patient conditions.
• Contributes to monthly utilization data trends using hospital data tools.
• Facilitates physician reviews with payers as required.
• Performs other duties as assigned.

Skills

Utilization Management experience

Behavioral health experience

Education

RN licensure (MA)

LCSW/LICSW/LMHC licensure

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.