Utilization Review Coordinator

RemoteRemotemid

Sales

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Quick Summary

Key Responsibilities

Utilization Review on Behalf of the Clinics: Prescreen referrals to project/anticipate authorizations. Provide recommendations regarding level of care/services and treatment planning.

Requirements Summary

None Summary: The Utilization Review Coordinator will report directly to the Senior Director of RCM. This team member will be responsible for handling pre-certifications, authorizations,

Technical Tools

Sales

Guidelight Health is a cutting-edge behavioral healthcare company dedicated to transforming lives through high-quality PHP (Partial Hospitalization Program) and IOP (Intensive Outpatient Program) services. As a newly launched organization, we are on a mission to redefine the behavioral health industry by delivering exceptional care, utilizing state-of-the-art facilities, and prioritizing the well-being of those we serve. At Guidelight Health, we are building a team of passionate, forward-thinking professionals who are eager to be part of this exciting journey to reshape mental health care. Join us in making a lasting impact!

Responsibilities

~1 min read

→Bachelor's degree in Social Work, Nursing, or any related field.
→Clinical or UR experience in PHP or IOP levels of care.
→1-2 years of experience in the healthcare industry in utilization review or clinical care.
→Expert understanding of patient documentation, chart auditing, and state and federal regulations.
→Proficient in MS Office applications and ability to learn department and job-specific software systems (e.g., applicable practice management and EMR systems)
→Demonstrate organizational skills.
→Demonstrate effective verbal and written communication skills.
→Demonstrate analytical skills when problem-solving.
→Demonstrate high attention to detail and a high degree of accuracy.

Pay Range

$20—$30 USD

What We Offer

~1 min read

✓Health & Wellness: Medical, dental, vision, HealthJoy unlimited therapy, UHC wellness program, HSA/FSA options, and pet insurance.

✓Time Off: Responsible PTO, in lieu of a traditional accrual-based policy, which allows full-time and part-time employees to take the time they need, when they need it, while ensuring continuity of care and team collaboration

✓401(k): With company match.

✓Licensing: All licensing fees covered, including opportunities for cross-licensure when applicable.

✓Professional Development: Annual stipend for tuition reimbursement, ongoing education, or CEUs.

✓Clinical Supervision & Growth: Pre-licensed clinicians receive structured clinical supervision toward licensure, and all clinicians benefit from best-in-class supervision grounded in our state-of-the-art PHP/IOP curriculum.