Utilization Review (UR) / Utilization (UM) Coordinator

Utilization Review (UR) / Utilization Management (UM) Coordinator

The Utilization Review / Utilization Management Coordinator works closely with the other staff of Utilization Review/Management, Intake, Business Office, Medical Records, Clinical Staff, Nursing, and providers to coordinate and communicate patient information to insurance companies for the assignment of benefits. Performs clinical reviews over the telephone and electronically. Utilizes ASAM criteria (DSM-V) to determine appropriateness of admission, continued stay, discharge criteria and identifies high-risk cases. Adheres to accrediting and regulatory agency requirements in maintaining records to ensure compliance.

Turning Point Care Center, LLC has provided a place of healing and hope to adults who suffer from behavioral health disorders and/or substance abuse for more than 40 years. We are committed to providing quality behavioral health care through our inpatient and outpatient gender specific programs in Moultrie, GA. Our serene, rural setting gives patients a secure environment where they can build their foundation for lifelong recovery.

We offer a competitive and comprehensive benefits program including: Medical, Dental, Vision, Life Insurance, Flexible Spending Accounts, Health Savings Accounts, Short and Long Term Disability, 401K with match, Employee Stock Purchase Plan and additional voluntary benefits and discounts.

Qualifications: Licensure through state composite board for nursing or counseling/therapy: Minimum RN, LMSW, LAPC, LAMFT Preferred BSN, MSN, LCSW, LPC, LMFT Three (3) years of experience in chart analysis, utilization review, medical/clinical terminology, and acuity of illness Knowledge and understanding of a variety of insurances including: Traditional Medicare, Medicare Advantage Plans, and Commercial Plans Knowledge and experience with chemical dependency programs, mental health programs, situational evaluations, and crisis intervention, preferred.

Universal Health Services is one of the nation's largest and most respected providers of hospital and healthcare services. 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.