Utilization Review Specialist

Job Summary

Seeking a confident and detail-oriented Utilization Review Specialist, the full-time remote position will involve reviewing clinical documentation, managing insurance authorizations, and collaborating with providers to ensure timely care for clients in a behavioral health facility.

Key responsibilities

• Conduct utilization reviews and obtain prior authorizations from insurance companies
• Monitor continued stay and discharge criteria for clients
• Maintain accurate documentation to ensure compliance with insurance and regulatory standards

Required qualifications

• Preferred background or experience in social work, counseling, or behavioral health
• Experience in utilization review or case management for behavioral health
• Strong organizational skills and ability to work efficiently in a fast-paced environment
• Confident, proactive, and dedicated work ethic