Utilization Review Nurse (RN)

Universal Hospital Services Inc.

Westwood (GA)

On-site

USD 65,000 - 85,000

Full time

5 days ago

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Job summary

Lighthouse Care Center of Augusta is seeking a dedicated Utilization Review Nurse to join our growing team. This role requires coordination with physicians, therapists and staff to secure precertifications and continued authorization for patients in a behavioral health setting.

Preference for a Registered Nurse or Licensed Practical Nurse with GA licensure and at least 2 years of psychiatric care and utilization review experience. Strong data gathering and cross-team communications are essential.

Qualifications

RN or LPN with GA license, preferred RN
2 years of psychiatric healthcare experience and utilization review
Current GA or multistate RN/LPN license

Responsibilities

Review clinical content of medical records
Participate in treatment team meetings
Collaborate with physicians, therapists, nurses and staff to gather data for insurers to obtain precertification and continued authorization
Input pre-certifications and stay reviews into Midas
Follow-up on unfinished pre-certifications from the day before
Coordinate with treatment team on follow-ups
Verify insurance coverage at month start and post patient payments into MS4
Gather and enter clinical criteria into computer systems

Skills

RN/LPN license

Psychiatric care

Utilization review

Team collaboration

Education

RN or LPN license

GA multistate license

Tools

Midas

MS4

Job description

Responsibilities

Lighthouse Care Center of Augusta is seeking a dedicated, compassionate Utilization Review Nurse to add to our growing team.

Lighthouse Care Center of Augusta (LCCA)is a multi-discipline behavioral healthcare center that offers mental health services to the communities of surrounding Augusta, Georgia. The Lighthouse Care Center of Augusta is an acute and residential treatment facility providing balanced, top-notch clinical care to children, adolescents and young adults. We provide a carefully-structured and supportive environment, and our education program is accredited through the Georgia Accrediting Commission. Utilization Review Nurse. Under the direction of the Director of Utilization Management.

Website:https://www.LighthouseCareCenters.com

Job Duties/ Responsibilities:

Review clinical content of medical records
Participate in treatment team meetings
Collaborate with physicians, therapist, nurses and pertinent staff on gathering the necessary data to communicate with insurance companies/authorizing entities to ensure initial precertification and continued authorization is achieved
Utilization Review/Business Office Coordinator will ensure input of pre-certifications and continued stay reviews into Midas
Follow-up on unfinished pre-certifications from the day before
Coordinate with the treatment team on any follow-ups necessary
Verify insurance coverage at the first of the month, and post patient payments into MS4
Trained in all aspects relative to timely gathering clinical criteria, communication of clinical criteria, and entry of supporting clinical criteria into computer based systems
Additional job duties

Benefit Highlights:

Referral Bonus Program
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
Career development opportunities within UHS and its 300+ Subsidiaries!
More information is available on our Benefits Guest Website:uhsguest.com

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 itsinceptioninto an esteemed Fortune 500 corporation, annualrevenuesduring2025were$17.4billion.In 2026,UHS was again recognized as one of Fortune World's Most Admired Companies™ and in 2025, waslisted in Forbes ranking of America’s Largest Public Companies. Headquarteredin King of Prussia, PA, UHS has approximately101,500employeesand continues to grow through its subsidiaries. Operating acute care hospitals, behavioral health facilities, outpatient facilities and ambulatory care access points, an insurance offering, a physiciannetworkand various related serviceslocatedin 40U.S.states, Washington, D.C., PuertoRicoand the United Kingdom.Foradditionalinformationvisit www.uhs.com.

Qualifications

Education and Experience:

Registered Nurse (RN) preferred or License Professional Nurse (LPN)
Current GA or Multistate Valid RN or LPN license
Must have 2 years of experience in a psychiatric health care setting, delivery of care to psychiatric and/or chemically dependent patients and utilization review

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.

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