Utilization Review Coordinator

Position: Utilization Review Coordinator 

Job Type: Full Time  

Location: Remote  

Schedule: Monday to Friday 8:00am to 5:00pm 

Compensation: $62,000 $70,000 yearly salary  

About The Role  

The Utilization Review Coordinator (UR Coordinator) plays a crucial role in managing all utilization reviews for Sandstone Care's detox, residential, partial hospitalization, intensive outpatient, and outpatient programs. This position involves conducting pre-authorization and concurrent reviews of medical records to ensure that admission criteria, treatment plans, and continued stays align with industry standards and support timely discharge planning. The UR Coordinator facilitates communication between third-party payers and clinical staff, ensuring that medical records accurately reflect the intensity and level of services provided. This role is integral in maintaining compliance with Joint Commission, federal, and state regulations. 

Key Responsibilities: 

• Manage pre-authorization requests and concurrent reviews by analyzing insurance, governmental, and accrediting agency standards for admissions, treatment, and length of stay. 
• Collaborate with clinical and medical personnel to determine appropriate length of stay and ensure documentation meets criteria. 
• Ensure compliance with clinical program policies, collaborating with the Clinical Director and Program Manager to implement necessary quality improvements. 
• Support therapeutic services by conducting assessments, treatment planning, and coordinating clinical services with families, ensuring timely documentation for billing. 
• Lead weekly clinical meetings to discuss utilization review, treatment progress, discharge planning, and follow-up care. 
• Participate in recruiting competent clinicians to provide high-quality mental health and substance abuse services. 
• Maintain effective communication with families, referral agencies, and other community resources, fostering strong public relations. 
• Demonstrate strong decision-making skills, emotional stability, and judgment under pressure, ensuring a positive and supportive environment for both clients and staff. 

Qualifications: 

• Education: Bachelor's degree required; master’s degree in behavioral health science preferred (Clinical Social Work, Clinical Psychology, Marriage and Family Therapy, or related field). 
• Licenses/Certifications: Licensed Practitioner in Colorado preferred 
• Experience: Minimum of 3 years of clinical experience, with a background in substance abuse treatment, preferably in detox, residential, PHP, or IOP settings. 
• Skills & Abilities: 
  • Ability to analyze medical records and make informed decisions regarding admissions and treatment plans. 
  • Strong interpersonal and communication skills for collaborating with the medical/clinical team, clients, and external partners. 
  • Demonstrated expertise in treatment planning and discharge coordination. 
  • Ability to manage stressful situations and meet deadlines while maintaining professionalism and composure. 
  • Proficient in administrative tasks, including documentation and record-keeping for billing. 

Other Requirements: 

• Candidates applying for this position should be aware that an offer for employment in this position is contingent upon passing a comprehensive background check, encompassing criminal records and motor vehicle reports. 

The Perks 

At Sandstone Care, we believe that great care starts with our employees. That’s why we offer a comprehensive benefits package to support you in your personal and professional journey. Some of the benefits include: 

• A competitive compensation and total rewards package including a meaningful hourly rate, bonus incentive programs, merit- package including a meaningful hourly rate, bonus incentive programs, merit-based pay increases, 401k with a 5% company match, and professional growth opportunities. 
• A flexible PTO package that includes accrued PTO, paid holidays, and wellbeing days. 
• High quality medical, dental, and vision insurance with a variety of package options that meet your needs and majority company paid.  
• A robust Employee Assistance Program: Including counseling, legal consultations, financial planning, and wellness coaching. 
• A collaborative and supportive community of team members: Fostering a positive work environment. 

What to Expect: Our Interview Process 

Here's an overview of what comes next: 

• Application Review: We'll promptly review your application within one business day. 
• Discovery Call: Expect a 30–45-minute discovery call with one our Recruiters 
• Supervisor Interview:  Expect a 1 hour video interview with the hiring manager, followed by a panel interview with members of the UR Team. 
• Offer: If all goes well, you'll receive an offer. 

Expected Interview Timeline: The entire process typically takes 2-3 weeks. 

Sandstone Care’s Commitment to Diversity, Equity, & Inclusion  

At Sandstone Care, we are committed to fostering a culture of diversity, equity, and inclusion that not only enriches the lives of our employees but also ensures the wellbeing and care of our clients, regardless of their race, ethnicity, gender identity, sexual orientation, socioeconomic status, age, ability, or background. We believe that embracing diversity and promoting equity and inclusion are integral to our mission of providing high-quality behavioral health services. 

Sandstone Care is an equal opportunity employer and prohibits discrimination and harassment of any kind. We are committed to creating a diverse and inclusive workplace where all employees feel valued, respected, and empowered. We do not discriminate based on race, color, religion, creed, age, sex, national origin, ancestry, marital status, veteran status, sexual orientation, gender identity, disability, or any other legally protected status. All employment decisions are based on qualifications, merit, and business needs.