D107 - C&A MH Crisis - Utilization Management Coordinator

Utilization Management Coordinator   Company Overview: At River Edge Behavioral Health in Macon, GA, employees are expected to develop meaningful relationships with patients, establishing trust and making a difference in the lives of clients and their families. We believe in supporting our team as well as our clients with our comprehensive benefits package and a supportive work culture, including health, dental, and vision benefits, paid vacation, retirement plans, and more.   Position Overview: The Utilization Management Coordinator role is focused on ensuring clients receive the appropriate level of behavioral health care while maintaining compliance with medical necessity, authorization, and documentation requirements. The position combines utilization review, care coordination, insurance authorization management, and administrative oversight within behavioral health services.   Location/Schedule: 3575 Fulton Mill Road, Macon, GA – 36 hour – 3–12-hour shifts between Sunday-Saturday 7am-7pm or 7pm-7am.   Key Responsibilities Create Connects batch files  Retrieve and process response files from Beacon’s SFTP site  Work Connects documents in rejected, denied, hold, no CID, multi-final payer and status appropriately  Review discharge connects and flip to UM complete  Manage and process BHL CSU authorizations and update Carelogic  Review and process AC file for BHL CSU authorization  Complete State Discharge process for Fulton locations  Create PTRF referral via Beacon authorization request  Review and process Connects documents in UM review    Qualifications High School Diploma (Bachelors in helping profession such as social work, community counseling, counseling psychology, or criminology preferred)  1-3 years of utilization management experience    Additional Benefits: Flexible spending accounts 11 Paid holidays Voluntary Life Insurance