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UHS·Portsmouth, Virginia
Utilization Review Coordinator
Computed from live listings
The role focuses on coordinating resident care through case management, utilization review, and discharge planning to ensure cost-effectiveness and continuity of care. It involves facilitating communication between payers, referral sources, and clinical teams to secure financial resources and recertifications.
Needs basic understanding of and comfort level with medical terminology, residential treatment, clinical science/pathology and psychiatric disorders. Must know how to gather and analyze data. Must be articulate, assertive, and able to communicate effectively with families, payers, therapists and physicians both verbally and in writing. Must also demonstrate initiative, tact and good judgment. Must be able to acquire clear understanding of treatment priorities and ability to make sound decisions balancing resident and family needs with available resources. Must have basic computer skills. An individual must be able to perform each essential function of the job satisfactorily. Reasonable accommodations may be made to enable individuals with disabilities, who are otherwise qualified, to perform the essential functions.
Prefer a Bachelor’s Degree in social work, psychology or counseling with documented field work experience.
Candidates should ideally hold a Bachelor's degree in social work, psychology, or counseling and have at least four years of experience in nursing, mental health, or admissions. Proficiency in DMAS regulations and experience with Acentra/Kepro or Humana/Tricare portals is highly preferred.
Market context
Behavioral-health roles in Virginia commonly draw steady demand as agencies and treatment programs look for clinicians who can support counseling, care coordination, and recovery services. These positions are competitive because a valid CSAC license is required, while a psychology or counseling degree and treatment-industry experience are preferred; benefits often include PTO and health-related coverage. Review the AI-summarized requirements and benefits on this platform to save time, and confirm your licensure details before applying.