The posting
Responsibilities FHCHS of PR, Inc. organization with extensive experience in managing mental health benefits and developing solutions that promote the emotional well-being of individuals, families, workplaces, and communities. Since our foundation in 1996, at FHC Mental Health, we have worked to facilitate access to excellent mental health services and support people at different stages of their lives. Our experience has allowed us to evolve, expand our services, and develop integrated solutions that promote prevention, guidance, recovery, and continuity of care. Website: https://fhcsaludmental.com/ The Utilization Review Coordinator (URC) is responsible for initial clinical review. URC may approve requests for admissions, procedures, and services that meet clinical review criteria, but must refer requests that do not meet clinical review criteria to peer clinical review for certification or non-certification. Responsibilities and essential duties: Visits the hospital facilities or receives the documentation via fax and perform the initial review of the clinical information. Discuss the cases with the psychiatrists, psychologists, or social workers as appropriate to discuss medical necessity criteria for authorizations. Maintains the daily census of the assigned facilities. Responsible for making sure that the peer-to-peer discussion takes place. Issues the services authorizations after the review is completed. Maintains updated utilization review documentation in the platforms. Documents and reports in the system the ineligible cases. Provides the daily utilization data of the facilities assigned. Maintains a registry of all cases by facility/providers and account in the UMP platform. Participate in the departmental meetings. Keeps the specialization license and professional association membership effective. Complies with the continuing education hours that correspond to the specialization. Participates in the mandatory training courses, such as: the annual compliance plan, and updated clinical criteria. Inform the supervisor or human resources of any sanction or revocation of the license that affects the practice of the profession. Comly with standards of Service Excellence Program. Available to travel throughout Puerto Rico. Conduct prospective, concurrent, retrospective review and discharge planning. Responsible to evaluate the quality, medical necessity and services provided. Provide guidance to the non-clinical staff as needed. URC must provide written notices to the members and providers via fax, mail and/or secure email. Qualifications 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. Headquarters in King of Prussia, PA, UHS has approximately 101,500 employees and continue 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.
