Responsibilities

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.

Website: https://cumberlandhallhospital.com/

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:

Retention Bonus Program if offered.
Loan Forgiveness Program if offered.
Challenging and rewarding work environment
Competitive Compensation & 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
Tuition savings to continue your nursing education with Chamberlain University
Career development opportunities within UHS and its 300+ Subsidiaries!
Pet Insurance
More information is available on our Benefits Guest Website: uhsguest.com

About Universal Health Services

Headquartered in King of Prussia, PA, Universal Health Services, Inc. (NYSE: UHS) is one of the nation’s largest and most respected providers of hospital and healthcare services. Since our founding in 1979, UHS has grown steadily into a premier Fortune 500® corporation perennially recognized by multiple esteemed national rating entities. Through its subsidiaries, UHS operates inpatient acute care facilities, inpatient behavioral health facilities, outpatient and other facilities, nationwide virtual behavioral health services, an insurance offering, a physician network and various related services with physical locations in the U.S., Puerto Rico, Ireland and United Kingdom. www.uhs.com.

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.

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At UHS and all our subsidiaries, our Human Resources departments and recruiters are here to help prospective candidates by matching skill set and experience with the best possible career path at UHS and our subsidiaries. During the recruitment process, no recruiter or employee will request financial or personal information (e.g., Social Security Number, credit card or bank information, etc.) from you via email. Our recruiters will not email you from a public webmail client like Hotmail, Gmail, Yahoo Mail, etc.

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Learn more about this Employer on their Career Site

UR COORDINATOR (RN OR MSW)