Utilization Review Coordinator
Universal Health Services
Utilization Review (UR) / Utilization Management CoordinatorThe 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.Join our team and discover a rewarding, fulfilling career. 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. 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.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 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.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.
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