Utilization Review (UR) Coordinator

Are you passionate about making a difference in the lives of others?

Since 1938 we have grown to over 70 programs, providing assistance to individuals and families throughout the Diocese of Paterson and beyond - we provide help and create hope for thousands of people each day. Our ability to deliver support, education, sustenance and so much more to those in need is extensive. Through Catholic Family and Community Services, the Department for Persons with Disabilities and Straight and Narrow we offer life-changing resources in multiple facets for the families and individuals we serve. We truly have a rich history of providing essential services to our communities.

TITLE: Utilization Review (UR) Coordinator

Location: Parsippany NJ

Hours: Full Time (Monday through Friday: 8:30am - 4:30pm)

This is an hourly non-exempt position.

Salary: Up to $32.80 (with experience)

Job Summary

The Utilization Review Coordinator is responsible for securing and maintaining payer authorizations for behavioral health services, ensuring medical necessity, appropriate level of care placement, and reimbursement optimization. This role serves as the liaison between clinical teams, admissions, and insurance payers to support continuity of care and financial sustainability.

Qualifications

• Bachelor's degree required, master's preferred

• 2-5+ years in behavioral health, substance use treatment, or utilization review
• Experience with insurance authorization processes and medical/clinical necessity criteria
• Familiarity with ASAM criteria strongly preferred

• Strong clinical documentation review skills
• Knowledge of payer systems (State Contracts, FFS Initiatives, Medicaid, MCO, Third Party)
• Excellent communication and negotiation skills
• Detail-oriented with strong organizational abilities
• Ability to manage multiple cases and deadlines

Benefits: For full time positions, (30+ per week) we offer:

• We provide PAID training
• Medical/vision and dental
• Life insurance (agency-paid), supplemental life insurance (employee-paid)
• Flexible spending accounts
• Accidental/Critical Illness Insurance
• 403B (with company-matching)
• Generous paid time off

All offers of employment are contingent on the successful completion/passing of our criminal background/references/DMV check, fingerprinting, pre-employment physical and drug test, etc.