UR COORDINATOR (RN OR MSW)

Utilization Review Coordinator Opportunity

Cumberland Hall Hospital is a 97 bed, licensed, acute psychiatric hospital located in beautiful Hopkinsville, KY. Cumberland Hall features individual units for youth, adults and active-duty military, and offers inpatient acute care, partial hospitalization, and intensive outpatient programs. On average, over 1500 patients receive care from our compassionate health care team each year at Cumberland Hall Hospital.

The Utilization Review Coordinator is responsible for evaluating and coordinating patient care services to ensure medical necessity, appropriate level of care, and compliance with insurance and regulatory requirements. This role works closely with clinical staff, physicians, and insurance providers to obtain authorizations, support reimbursement, minimize denials, and promote efficient utilization of hospital resources while maintaining quality patient care.

Job duties to include:

• Review admissions and continued stays for medical necessity.
• Obtain and maintain insurance authorizations and approvals.
• Communicate with payers regarding clinical information and coverage.
• Monitor authorization status and help prevent reimbursement denials.
• Coordinate with treatment teams on level-of-care decisions.
• Maintain accurate utilization review and authorization records.
• Assist with denial management, appeals, and peer reviews.
• Ensure compliance with payer, regulatory, and hospital requirements.

Benefits for staff include:

• Challenging and rewarding work environment
• Competitive compensation and 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
• Retention bonus program
• Career development opportunities within UHS and its 300+ subsidiaries!

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 were $15.8 billion in 2024. UHS was again recognized as one of the World's Most Admired Companies by Fortune; and listed in Forbes ranking of America's Largest Public Companies. Headquartered in King of Prussia, PA, UHS has approximately 99,000 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 all over the U.S. States, Washington, D.C., Puerto Rico and the United Kingdom.

Qualifications:

Utilization Review Coordinator Requirements:

Education: Masters prepared in Social Work or Licensed Registered Nurse

Experience: Two years psychiatric experience with knowledge of psychotropic medications.

Licenses/Certificates: Current nursing license to practice in Kentucky or master's degree in social work

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.