The Utilization Review Coordinator possesses knowledge of psychiatric clinical diagnosis and the ... The UM Coordinator leads physician daily treatment team meetings, manages authorizations and ...
The Utilization Review Coordinator possesses knowledge of psychiatric clinical diagnosis and the ... The UM Coordinator leads physician daily treatment team meetings, manages authorizations and ...
Prior Authorization Specialist - Radiation Oncology - Full Time
Montrose, CO · On-site
$17.25 - $22.75/hr
Secondly, the Prior Authorization Specialist minimizes the patient's financial risk with a thorough review of the health plan benefits and coverage restrictions, proactively advising the provider and ...
Prior Authorization Specialist - Radiation Oncology - Full Time
Montrose, CO · On-site
$17.25 - $22.75/hr
Secondly, the Prior Authorization Specialist minimizes the patient's financial risk with a thorough review of the health plan benefits and coverage restrictions, proactively advising the provider and ...
Prior Authorization Specialist and Scheduler - Urology - Full Time
Montrose, CO · On-site
$20.62 - $34.57/hr
Secondly, the Prior Authorization Specialist minimizes the patient's financial risk with a thorough review of the health plan benefits and coverage restrictions, proactively advising the provider and ...
Quick apply
Prior Authorization Specialist and Scheduler - Urology - Full Time
Montrose, CO · On-site
$20.62 - $34.57/hr
Secondly, the Prior Authorization Specialist minimizes the patient's financial risk with a thorough review of the health plan benefits and coverage restrictions, proactively advising the provider and ...
Prior Authorization Specialist and Scheduler - Urology - Full Time
Montrose, CO · On-site
$20.62 - $34.57/hr
Secondly, the Prior Authorization Specialist minimizes the patient's financial risk with a thorough review of the health plan benefits and coverage restrictions, proactively advising the provider and ...
Prior Authorization Specialist and Scheduler - Urology - Full Time
Montrose, CO · On-site
$20.62 - $34.57/hr
Secondly, the Prior Authorization Specialist minimizes the patient's financial risk with a thorough review of the health plan benefits and coverage restrictions, proactively advising the provider and ...
Prior Authorization Specialist and Scheduler - Urology - Full Time
Montrose, CO · On-site
$17.25 - $22.75/hr
Secondly, the Prior Authorization Specialist minimizes the patient's financial risk with a thorough review of the health plan benefits and coverage restrictions, proactively advising the provider and ...
Prior Authorization Specialist and Scheduler - Urology - Full Time
Montrose, CO · On-site
$17.25 - $22.75/hr
Secondly, the Prior Authorization Specialist minimizes the patient's financial risk with a thorough review of the health plan benefits and coverage restrictions, proactively advising the provider and ...
Prior Authorization Specialist and Scheduler - Urology - Full Time
Montrose, CO · On-site
$20.62 - $34.57/hr
Secondly, the Prior Authorization Specialist minimizes the patient's financial risk with a thorough review of the health plan benefits and coverage restrictions, proactively advising the provider and ...
Prior Authorization Specialist and Scheduler - Urology - Full Time
Montrose, CO · On-site
$20.62 - $34.57/hr
Secondly, the Prior Authorization Specialist minimizes the patient's financial risk with a thorough review of the health plan benefits and coverage restrictions, proactively advising the provider and ...
Prior Authorization Specialist and Scheduler - Urology - Full Time
Montrose, CO · On-site
$20.62 - $34.57/hr
Secondly, the Prior Authorization Specialist minimizes the patient's financial risk with a thorough review of the health plan benefits and coverage restrictions, proactively advising the provider and ...
Prior Authorization Specialist and Scheduler - Urology - Full Time
Montrose, CO · On-site
$20.62 - $34.57/hr
Secondly, the Prior Authorization Specialist minimizes the patient's financial risk with a thorough review of the health plan benefits and coverage restrictions, proactively advising the provider and ...
Prior Authorization Specialist I, Hospital Admissions, Full-Time
Grand Junction, CO · On-site
$19 - $21.85/hr
Position Highlights: * Position: Prior Authorization * Location: Hospital Admissions ... Collect and review patient medical records, diagnosis codes, and procedure details to support the ...
Prior Authorization Specialist I, Hospital Admissions, Full-Time
Grand Junction, CO · On-site
$19 - $21.85/hr
Position Highlights: * Position: Prior Authorization * Location: Hospital Admissions ... Collect and review patient medical records, diagnosis codes, and procedure details to support the ...
Prior Authorization Specialist I, Hospital Admissions, Full-Time
Grand Junction, CO · On-site
$19 - $21.85/hr
Position Highlights: * Position: Prior Authorization * Location: Hospital Admissions ... Collect and review patient medical records, diagnosis codes, and procedure details to support the ...
Prior Authorization Specialist I, Hospital Admissions, Full-Time
Grand Junction, CO · On-site
$19 - $21.85/hr
Position Highlights: * Position: Prior Authorization * Location: Hospital Admissions ... Collect and review patient medical records, diagnosis codes, and procedure details to support the ...
Position Highlights: * Position: Prior Authorization * Location: Hospital Admissions ... Collect and review patient medical records, diagnosis codes, and procedure details to support the ...
Position Highlights: * Position: Prior Authorization * Location: Hospital Admissions ... Collect and review patient medical records, diagnosis codes, and procedure details to support the ...
Prior Authorization Specialist I, Hospital Admissions, Full-Time
Grand Junction, CO · On-site
$19 - $21.85/hr
Position Highlights: * Position: Prior Authorization * Location: Hospital Admissions ... Collect and review patient medical records, diagnosis codes, and procedure details to support the ...
Quick apply
Prior Authorization Specialist I, Hospital Admissions, Full-Time
Grand Junction, CO · On-site
$19 - $21.85/hr
Position Highlights: * Position: Prior Authorization * Location: Hospital Admissions ... Collect and review patient medical records, diagnosis codes, and procedure details to support the ...
Insurance Authorization Specialist
Colorado Springs, CO · On-site
$20 - $24/hr
Review and process prior authorization requests for various behavioral health and medical services in accordance with insurance guidelines. * Verify insurance coverage and benefits for clients by ...
Quick apply
Insurance Authorization Specialist
Colorado Springs, CO · On-site
$20 - $24/hr
Review and process prior authorization requests for various behavioral health and medical services in accordance with insurance guidelines. * Verify insurance coverage and benefits for clients by ...
Prior Authorization Specialist I, Hospital Admissions, PRN/Pool
Grand Junction, CO · On-site
$19 - $21.85/hr
Position Highlights: * Position: Prior Authorization * Location: Hospital Admissions ... Collect and review patient medical records, diagnosis codes, and procedure details to support the ...
Prior Authorization Specialist I, Hospital Admissions, PRN/Pool
Grand Junction, CO · On-site
$19 - $21.85/hr
Position Highlights: * Position: Prior Authorization * Location: Hospital Admissions ... Collect and review patient medical records, diagnosis codes, and procedure details to support the ...
Manager, Medical Utilization and Care Management
Denver, CO · On-site
$95K - $130K/yr
Provide oversight of vendor-managed prior authorization, peer-to-peer review, denial, appeal, and ... Review utilization trends and vendor performance data to identify quality improvement opportunities ...
Manager, Medical Utilization and Care Management
Denver, CO · On-site
$95K - $130K/yr
Provide oversight of vendor-managed prior authorization, peer-to-peer review, denial, appeal, and ... Review utilization trends and vendor performance data to identify quality improvement opportunities ...
Manager, Medical Utilization and Care Management
Denver, CO · On-site
$95K - $130K/yr
Provide oversight of vendor-managed prior authorization, peer-to-peer review, denial, appeal, and ... Review utilization trends and vendor performance data to identify quality improvement opportunities ...
Manager, Medical Utilization and Care Management
Denver, CO · On-site
$95K - $130K/yr
Provide oversight of vendor-managed prior authorization, peer-to-peer review, denial, appeal, and ... Review utilization trends and vendor performance data to identify quality improvement opportunities ...
Remote Utilization Manager - Inpatient
Littleton, CO · Remote
$75K - $83K/yr
Advocate for clients by communicating clinical information to secure timely and appropriate care authorizations * Lead utilization reviews for clients in our Acute Treatment and Crisis Stabilization ...
Remote Utilization Manager - Inpatient
Littleton, CO · Remote
$75K - $83K/yr
Advocate for clients by communicating clinical information to secure timely and appropriate care authorizations * Lead utilization reviews for clients in our Acute Treatment and Crisis Stabilization ...
Remote Utilization Manager - Inpatient
Watkins, CO · Remote
$75K - $83K/yr
Advocate for clients by communicating clinical information to secure timely and appropriate care authorizations * Lead utilization reviews for clients in our Acute Treatment and Crisis Stabilization ...
Remote Utilization Manager - Inpatient
Watkins, CO · Remote
$75K - $83K/yr
Advocate for clients by communicating clinical information to secure timely and appropriate care authorizations * Lead utilization reviews for clients in our Acute Treatment and Crisis Stabilization ...
... authorizations/reauthorizations and reviews. The UM coordinator must be able to work with the ... are approved prior to admission or prior to transfer/discharge to other levels of care.
... authorizations/reauthorizations and reviews. The UM coordinator must be able to work with the ... are approved prior to admission or prior to transfer/discharge to other levels of care.
Prior Authorization Specialist I, Hospital Admissions, PRN/Pool
Grand Junction, CO · On-site
$19 - $21.85/hr
Position Highlights: * Position: Prior Authorization * Location: Hospital Admissions ... Collect and review patient medical records, diagnosis codes, and procedure details to support the ...
Quick apply
Prior Authorization Specialist I, Hospital Admissions, PRN/Pool
Grand Junction, CO · On-site
$19 - $21.85/hr
Position Highlights: * Position: Prior Authorization * Location: Hospital Admissions ... Collect and review patient medical records, diagnosis codes, and procedure details to support the ...
Manager, Medical Utilization and Care Management
Denver, CO · On-site
$95K - $130K/yr
Provide oversight of vendor-managed prior authorization, peer-to-peer review, denial, appeal, and ... Review utilization trends and vendor performance data to identify quality improvement opportunities ...
Manager, Medical Utilization and Care Management
Denver, CO · On-site
$95K - $130K/yr
Provide oversight of vendor-managed prior authorization, peer-to-peer review, denial, appeal, and ... Review utilization trends and vendor performance data to identify quality improvement opportunities ...
Prior Authorization Utilization Review information
What are the key skills and qualifications needed to thrive as a Prior Authorization Utilization Review specialist?
How do I get into a prior authorization utilization review?
What is a Prior Authorization Utilization Review specialist?
What is the difference between Prior Authorization Utilization Review vs Medical Reviewer?
| Aspect | Prior Authorization Utilization Review | Medical Reviewer |
|---|---|---|
| Credentials | Licensed healthcare professionals, often with certifications in utilization review | Licensed physicians or healthcare providers with clinical expertise |
| Work Environment | Insurance companies, healthcare organizations, or third-party review firms | Hospitals, clinics, insurance companies, or consulting firms |
| Primary Focus | Assessing the necessity of procedures or treatments before approval | Evaluating clinical records to determine medical necessity and appropriateness |
While both roles involve clinical assessment, Prior Authorization Utilization Review focuses on pre-authorization decisions for treatments, whereas Medical Review involves detailed clinical evaluation of patient records to determine medical necessity. Both require healthcare credentials and are integral to healthcare quality and cost management.
Is prior authorization utilization review a stressful job?
What are some common challenges faced by professionals in Prior Authorization Utilization Review roles, and how can these be managed?
- No Experience Utilization Management Nurse
- Utilization Review Physician
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- Evening Utilization Review Nurse
- Behavioral Health Utilization Review
- Per Diem Utilization Review Nurse
- Utilization Review Specialist
- Utilization Management
- Home Based Utilization Review Nurse
- Non Clinical Utilization Review
Full-time
Medical, Dental, Vision, Retirement, PTO
Posted 28 days ago
Universal Health Services rating
6.8
Based on 253 frontline employees who took The Breakroom Quiz
493rd of 887 rated healthcare providers
Job description
This position is required to be onsite!
Highlands Behavioral Health System is an 86 bed, acute care psychiatric hospital located in Littleton, CO. Highlands features individual units for adults, and seniors, and offers inpatient acute care, partial hospitalization, and intensive outpatient programs.
Website: https://highlandsbhs.com
The Utilization Review Coordinator possesses knowledge of psychiatric clinical diagnosis and the ability to articulate those indicators professionally. The UM Coordinator manages medical necessity by evaluating the patient medical records to determine severity of patient’s illness and determining the appropriateness of level of care. Serves as liaison for patients and hospital with insurance companies. Negotiates and advocates for patient length of stay and level of care. Oversees utilization review activities with other departments to ensure reimbursement for services provided by the hospital. The UM Coordinator leads physician daily treatment team meetings, manages authorizations and reviews for outpatient programming and at time of admission is responsible for obtaining the precertification. The UM coordinator must be able to work with the business office and admissions departments to complete preliminary verification of benefits. The UM Coordinator has a working knowledge of all levels of care offered and appropriately manages patient benefits.
Benefit & Reward Highlights:
- Tuition and Educational Reimbursement Program.
- Student Loan Repayment Program.
- Challenging and rewarding work environment
- Career development opportunities
- Competitive Compensation & Generous Paid Time Off
- Excellent Medical, Dental, Vision and Prescription Drug Plans
- Discounts on pet insurance, automotive insurance & homeowners insurance
- 401(K) with company match and discounted stock plan
- SoFi Student Loan Refinancing Program
Questions or concerns? Contact the Human Resources department at HIGHLANDSBHSHumanResourceContact@uhsinc.com.
Screening of applications begins immediately and continues until the position is filled.
Qualifications
Requirements:
- Masters prepared healthcare professional (Counseling, Psychology, or Social Work) required or RN with direct experience.
- Valid RN license, LCSW, or LPC preferred.
- A minimum of 3-5 years direct psychiatric patient care experience.
- Must possess knowledge of psychiatric care, utilization review, insurance reimbursement procedures, DSM-V, etc. Advanced computer skills necessary. Strong analytical, organizational, verbal and written skills required.
About Universal Health Services
One of the nation’s largest and most respected providers of hospital and healthcare services, Universal Health Services, Inc. (UHS) has built an impressive record of achievement and performance. Growing steadily since its inception into an esteemed Fortune 500® corporation, annual revenues during 2025 were $17.4 billion. In 2026, UHS was again recognized as one of Fortune World’s Most Admired Companies™ and in 2025, was listed in Forbes ranking of America’s Largest Public Companies.
Headquartered in King of Prussia, PA, UHS has approximately 101,500 employees and continues to grow through its subsidiaries. Operating acute care hospitals, behavioral health facilities, outpatient facilities and ambulatory care access points, an insurance offering, a physician network and various related services located in 40 U.S. states, Washington, D.C., Puerto Rico and the United Kingdom. For additional information visit www.uhs.com.
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.
Avoid and Report Recruitment Scams
We are aware of a scam whereby imposters are posing as Recruiters from UHS, and our subsidiary hospitals and facilities. Beware of anyone requesting financial or personal information.
At UHS and all our subsidiaries, our Human Resources departments and recruiters are here to help prospective candidates by matching skill set and experience with the best possible career path at UHS and our subsidiaries. During the recruitment process, no recruiter or employee will request financial or personal information (e.g., Social Security Number, credit card or bank information, etc.) from you via email. Our recruiters will not email you from a public webmail client like Hotmail, Gmail, Yahoo Mail, etc.
If you suspect a fraudulent job posting or job-related email mentioning UHS or its subsidiaries, we encourage you to report such concerns to appropriate law enforcement. We encourage you to refer to legitimate UHS and UHS subsidiary career websites to verify job opportunities and not rely on unsolicited calls from recruiters.
Qualifications:Requirements:
- Masters prepared healthcare professional (Counseling, Psychology, or Social Work) required or RN with direct experience.
- Valid RN license, LCSW, or LPC preferred.
- A minimum of 3-5 years direct psychiatric patient care experience.
- Must possess knowledge of psychiatric care, utilization review, insurance reimbursement procedures, DSM-V, etc. Advanced computer skills necessary. Strong analytical, organizational, verbal and written skills required.
About Universal Health Services
One of the nation’s largest and most respected providers of hospital and healthcare services, Universal Health Services, Inc. (UHS) has built an impressive record of achievement and performance. Growing steadily since its inception into an esteemed Fortune 500® corporation, annual revenues during 2025 were $17.4 billion. In 2026, UHS was again recognized as one of Fortune World’s Most Admired Companies™ and in 2025, was listed in Forbes ranking of America’s Largest Public Companies.
Headquartered in King of Prussia, PA, UHS has approximately 101,500 employees and continues to grow through its subsidiaries. Operating acute care hospitals, behavioral health facilities, outpatient facilities and ambulatory care access points, an insurance offering, a physician network and various related services located in 40 U.S. states, Washington, D.C., Puerto Rico and the United Kingdom. For additional information visit www.uhs.com.
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.
Avoid and Report Recruitment Scams
We are aware of a scam whereby imposters are posing as Recruiters from UHS, and our subsidiary hospitals and facilities. Beware of anyone requesting financial or personal information.
At UHS and all our subsidiaries, our Human Resources departments and recruiters are here to help prospective candidates by matching skill set and experience with the best possible career path at UHS and our subsidiaries. During the recruitment process, no recruiter or employee will request financial or personal information (e.g., Social Security Number, credit card or bank information, etc.) from you via email. Our recruiters will not email you from a public webmail client like Hotmail, Gmail, Yahoo Mail, etc.
If you suspect a fraudulent job posting or job-related email mentioning UHS or its subsidiaries, we encourage you to report such concerns to appropriate law enforcement. We encourage you to refer to legitimate UHS and UHS subsidiary career websites to verify job opportunities and not rely on unsolicited calls from recruiters.
Education:UNAVAILABLEEmployment Type: FULL_TIMEWhat Universal Health Services employees say
Pay
Benefits
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About Universal Health Services
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Universal Health Services (UHS) is a major player in the healthcare industry, based in King of Prussia, Pennsylvania, U.S. Founded in 1978, UHS offers hospital and healthcare services. Their diverse services range from acute care hospitals, behavioral health facilities and ambulatory centers nationwide. The company's mission of enhancing the health and well-being of their patients is reflected in their commitment to 'Helping Individuals Live Longer, Healthier and Happier Lives'. Universal Health Services' consistent growth and success in their industry have been recognized on numerous occasions, including being ranked amongst the Fortune 500 list of largest companies.
Industry
Health care and social assistance
Company size
10,000+ Employees
Headquarters location
King of Prussia, PA, US