Utilization Review Coordinator

Remotemid

OtherCoordinator

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Quick Summary

Overview

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

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.

Technical Tools

ms-officephpstrategic-planning

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.
→Must be based in PST, with an understanding of the west coast Payer landscape (ideally CA or WA).
→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

$70,000—$80,000 USD

What We Offer

~1 min read

At Guidelight, we value a work-life integration culture. This approach allows our teammates to focus on what matters most to them, while also caring for our clients and fellow teammates. We have found that this promotes a sustainable and successful culture, and we offer the following benefits to our teammates to demonstrate this commitment to each other. 

As a Guidelight teammate, working 32+ hours per week, you’ll enjoy a comprehensive benefits package, including:

✓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.