Lead Utilization Management Coordinator
UHS
Summary
The Utilization Management Lead supports the daily operations of utilization review activities, ensuring timely and accurate documentation, adherence to regulatory requirements, and effective communication with payers.
Job description
This role collaborates closely with clinical teams and leadership to promote patient satisfaction, regulatory compliance, and appropriate reimbursement.
The Lead serves as a resource for staff, helping to implement best practices and maintain workflow efficiency within the department.
Responsibilities
- Oversee daily utilization review activities
- Ensure timely and accurate documentation
- Adhere to regulatory requirements
- Communicate effectively with payers
- Collaborate with clinical teams and leadership
- Promote patient satisfaction and regulatory compliance
- Support appropriate reimbursement
- Implement best practices and maintain workflow efficiency
Requirements
- Master's Degree in a related mental health field
- Minimum of three (3) to five (5) years of experience in an acute inpatient psychiatric setting as a treatment team member, or 2-4 years of experience in utilization management for both mental health and substance abuse behavioral health disorders
- Current RN license to practice by the Illinois State Board of Nursing
- Social Work, Marriage and Family, Mental Health Counseling (i.e. LPC, LMHC, LCSW, LCPC, LPCC) preferred
- Primary Source Verification through Illinois Department of Professional Regulations
Benefits
- Paid Time Off
- Medical Insurance
- Dental Insurance
- Vision Insurance
- Prescription Drug Plans
- 401(k) with company match
- Discounted stock plan
- SoFi Student Loan Refinancing Program
- Career development opportunities
Company overview
Universal Health Services, Inc. (UHS) is one of the nation's largest and most respected providers of hospital and healthcare services, operating as a Fortune 300 corporation headquartered in King of Prussia, Pennsylvania. Founded in 1979, UHS has grown into a major healthcare enterprise with approximately 99,000 employees and annual revenues exceeding $14 billion. The company operates through its subsidiaries, managing 29 acute care hospitals, 331 behavioral health facilities, and 60 outpatient and other facilities across 39 U.S. states, Washington D.C., Puerto Rico, and the United Kingdom. UHS provides comprehensive healthcare services including acute care, behavioral health treatment, cancer centers, and ambulatory surgical centers. The company's strategy focuses on building or acquiring high-quality hospitals in rapidly growing markets and investing in advanced medical equipment and skilled personnel to become the leading healthcare provider in each community it serves. UHS is publicly traded on the New York Stock Exchange (NYSE: UHS) and has established a strong reputation for delivering compassionate, high-quality care while maintaining financial stability and operational excellence.