UHS·White County, Georgia
The coordinator reviews insurance benefits and determines the appropriate level of care based on ASAM criteria for clients. They are responsible for requesting authorizations, documenting approvals, and coordinating clinical needs with the treatment team.
Reviews and understands insurance information provided by the Call 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 client’s benefits. Once a care manager is established, contacts health plan provider and requests most appropriate LOC for client. Documents in system (NG, UR spreadsheet and Distribution spreadsheet) and in a paper file the request made and authorization approval number/contact information. Enters the appropriate LOC in Tier. This is based on the approved insurance LOC. This is updated throughout treatment as the insurance LOC is changed. Notifies Business Office within 24 hours of LOC step down or denial. Sends daily email with review outcomes to treatment staff indicating LOC, days approved and notification of LOC change. Coordinates and assist with scheduling peer reviews. Coordinates patient’s clinical and after-care needs with treatment team. Complete appeal and medical records as instructed. Education and Experience High School Degree or GED required, Bachelor's degree preferred Nursing degree or bachelor’s degree in psychology, social work, or related field preferred or commensurate experience acceptable. Minimum of 1 year 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 subsidiaries, our Human Resources departments and recruiters are here to help prospective candidates with matching skillset and experience with the best possible career 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 feel suspicious of a job posting or job-related email, let us know by contacting us at: https://uhs.alertline.com or 1-800-852-3449
A high school diploma or GED is required, while a bachelor's degree in nursing, psychology, or social work is preferred. Preference is given to candidates with at least one year of experience in utilization review or facility-based psychiatric/substance abuse care.
Market context
Behavioral health roles in Georgia are often competitive because employers look for candidates with a master’s degree in a related field or an active Georgia nursing license, plus prior behavioral health experience; inpatient experience is especially valued. Benefits commonly include medical, dental, vision, paid time off, and a 401(k) with company match. Review the AI-summarized requirements and benefits here to save time, then confirm your fit against the original posting before applying.