UHS·Bedford Charter Township, Michigan
The UR Coordinator reviews patient insurance benefits to determine available coverage and ascertains the appropriate level of care based on ASAM criteria. They coordinate clinical and after-care needs with the treatment team and document all authorization approvals.
The Utilization Review Coordinator is responsible for reviewing patient insurance benefits and ascertaining level of care (LOC) pre-certifications. Essential
Reviews and understands insurance information provided by the Admissions Center, determines which benefits are available to client, and clarifies discrepancies or confusion. Determines what LOC the client meets and what ASAM (American Society of Addiction Medicine) criteria support that LOC based on patient’s benefits. Once a care manager is established, contacts health plan provider and requests most appropriate LOC for client. Documents in system and in a paper file the request made and authorization approval number/contact information. Attends pass down/treatment team meetings as assigned, reviews weekly UR update information. Attends and participates in treatment team meetings and management meetings. Coordinates patient’s clinical and after-care needs with treatment team. Performs all other duties as required or assigned.
Must have high level of interpersonal skills. Position continually requires demonstrated poise, professionalism, tact and diplomacy. Specific knowledge of substance abuse and or mental health treatment on a clinical level. Ability to understand insurance benefits and follow insurance protocols within appropriate time frames. Ability to learn levels of care guidelines and medical necessity criteria. Must have strong knowledge of a variety of computer software applications in word processing and spreadsheets (MS Word, Excel). Excellent organizational skills with the ability to prioritize workload and meet deadlines. Ability to pay continual attention to detail in documenting files. Understands need for and maintains appropriate confidentiality at all times when interacting with patients, residents, families, visitors, referral sources and all other contacts. Exhibits excellent customer relation skills as evidenced by supportive and constructive communication with all contacts including coworkers, patients, residents, visitors, families and referral sources. Education and Experience Nursing degree or Bachelor’s degree in psychology, social work, or related field required or commensurate experience. Master’s degree preferred. Minimum of 1 years of experience in utilization review/case management preferred. Minimum of 1 year facility based psychiatric/substance abuse experience preferred. 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. We believe that diversity and inclusion among our teammates is critical to our success. Notice At UHS and all our subsidiaries, our Human Resources departments and recruiters are here to help prospective candidates by matching skillset and experience with the best possible career path at UHS and our subsidiaries. We take pride in creating a highly efficient and best in class candidate experience. During the recruitment process, no recruiter or employee will request financial or personal information (Social Security Number, credit card or bank information, etc.) from you via email. The recruiters will not email you from a public webmail client like Hotmail, Gmail, Yahoo Mail, etc. If you are suspicious of a job posting or job-related email mentioning UHS or its subsidiaries, let us know by contacting us at: https://uhs.alertline.com or 1-800-852-3449.
A nursing degree or bachelor's degree in psychology, social work, or a related field is required, with a master's degree preferred. Experience in utilization review, case management, or facility-based psychiatric/substance abuse treatment is preferred.
Market context
Behavioral health openings in Michigan often draw steady interest because employers need independently licensed clinicians who can provide consistent weekly availability. For this LMSW role, competition may center on licensure status, schedule flexibility, and readiness to meet a 25-session, 30-hour weekly commitment. Review the AI-summarized requirements and benefits here to save time versus reading the full posting, then confirm your Michigan licensure and availability before applying.