Utilization Management Coordinator
UHS
Summary
Lancaster Behavioral Health Hospital (LBHH) is a 126-bed, inpatient psychiatric hospital and joint venture between Lancaster General Health/Penn Medicine and Universal Health Services. In addition to a general adult unit and dedicated adolescent unit, the facility offers services for treating those with co-occurring disorders on the psychiatric-medical unit, an intensive adult unit to care for those with severe conditions, as well as a women's trauma unit.
Job description
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.
- Works collectively with hospital operations (social services, business office, Intake, Nursing) to ensure timely documentation is aligned with patient conditions.
- 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.
- Ensure that all denials are followed up weekly and documentation is detailed.
- Assures that Midas documentation is updated daily and appropriately. That all documentation has enough detail to ensure no issues with payment.
Qualifications
- Education: Bachelor's degree in psych related field and/or equivalent combination of education and experience. Masters preferred.
- Licensure: Registered Nurse or Social Work, Marriage and Family, Mental Health Counseling (i.e. LPC, LMHC, LCSW, LCPC, LPCC) preferred.
- Experience: 1 to 3 years of Utilization Management preferred.
Requirements
- Bachelor's degree in psych related field and/or equivalent combination of education and experience
- Masters preferred
- Registered Nurse or Social Work, Marriage and Family, Mental Health Counseling (i.e. LPC, LMHC, LCSW, LCPC, LPCC) preferred
- 1 to 3 years of Utilization Management preferred
Benefits
- Paid Time Off
- Medical Insurance
- Dental Insurance
- Vision Insurance
- Prescription Drug Plans
- Tuition Reimbursement
- 401(k) with company match
- Discounted stock plan
- SoFi Student Loan Refinancing Program
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.