Lead Utilization Management Coordinator

UHS•Streamwood, IL

7d•Onsite

About The Position

The Utilization Management Lead supports the daily operations of utilization review activities, ensuring timely and accurate documentation, adherence to regulatory requirements, and effective communication with payers. This role collaborates closely with clinical teams and leadership to promote patient satisfaction, regulatory compliance, and appropriate reimbursement. The Lead serves as a resource for staff, helping to implement best practices and maintain workflow efficiency within the department.

Requirements

A Master's Degree in a related mental health field is required.
A minimum of three (3) to five (5) years of experience in an acute inpatient psychiatric setting as a treatment team member, or 2-4 years of experience in utilization management for both mental health and substance abuse behavioral health disorders is required.
Current RN license to practice by the Illinois State Board of Nursing is required.

Nice To Haves

Social Work, Marriage and Family, Mental Health Counseling (i.e. LPC, LMHC, LCSW, LCPC, LPCC) preferred.
Primary Source Verification shall be required through Illinois Department of Professional Regulations.

Responsibilities

Supports the daily operations of utilization review activities.
Ensures timely and accurate documentation.
Ensures adherence to regulatory requirements.
Ensures effective communication with payers.
Collaborates closely with clinical teams and leadership to promote patient satisfaction, regulatory compliance, and appropriate reimbursement.
Serves as a resource for staff, helping to implement best practices and maintain workflow efficiency within the department.