Florida Licensed Utilization Review Specialist

Job Summary

Managing a caseload of 50-75 patients, the full-time Florida Licensed Utilization Review Specialist will conduct pre-authorization and concurrent reviews, verify insurance benefits, and collaborate with clinical teams to ensure compliance and support discharge planning in a remote setting.

Key responsibilities

• Authorize 15-25 cases daily while ensuring timely utilization reviews and appropriate levels of care
• Coordinate authorizations and communicate effectively with managed care providers
• Conduct admission and continuing-stay reviews to assess medical necessity and compliance with treatment standards

Required qualifications

• High School diploma or equivalent; graduate degree in a health or behavioral health-related field preferred
• Minimum of one year of experience in a utilization review position, preferably in psychiatric or chemical dependency