D107 - C&A MH Crisis - Utilization Management Coordinator

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.

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

• A High School Diploma (a Bachelor's degree in a helping profession such as social work, community counseling, counseling psychology, or criminology is preferred)
• 1-3 years of utilization management experience

Additional Benefits

• Flexible spending accounts
• 11 Paid holidays
• Voluntary Life Insurance

Company Overview

River Edge Behavioral Health serves more than 10,000 Georgians, providing mental health, substance use disorder treatments and supports as well as individuals with intellectual and development disabilities. River Edge offers outpatient services at its Emery Highway-Macon, Monroe County and Baldwin County locations. Outpatient services include behavioral health, nursing, and psychiatric assessment, stabilization and medication maintenance services as well as crisis intervention services as well as awareness, education and recovery groups. 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.