Utilization Review Specialist

EXCITING OPPORTUNITY WITH BANYAN TREATMENT CENTERS!

We are seeking a Utilization Review Specialist to join our corporate team in Pompano Beach, FL. The position is responsible for contacting external case managers and managed care organizations for pre-authorization and concurrent reviews for the duration of a patient’s treatment stay. They also establish and maintain contracts with managed care companies and requests rate increases when deemed appropriate.

POSITION DETAILS:

• Reports To: Director of Utilization Review
• Schedule: Full-Time, Weekdays (Weekend availability as needed).
• Location: Remote

KEY RESPONSIBILITIES:

* Manage a caseload of 50–75 patients and authorize 15–25 cases daily, ensuring timely utilization reviews and appropriate level of care. * Verify insurance benefits, coordinate authorizations, and communicate effectively with managed care providers. * Conduct admission and continuing-stay reviews to assess medical necessity and ensure compliance with treatment standards. * Collaborate with clinical and billing departments to support discharge planning, documentation, and timely reimbursement. * Identify and address over/underutilization trends and assist in resolving outstanding case issues with insurers.

REQUIREMENTS:

* High School diploma or equivalent; graduate degree in a health or behavioral health related field preferred. * Minimum of one-year experience working in a utilization review position (psychiatric or chemical dependency).

WHY JOIN BANYAN TREATMENT CENTERS?

This is more than a job, it’s a chance to be a vital part of what recovery looks like after treatment. As a Utilization Review Specialist, you’ll help ensure that each client leaves treatment with a clear plan, strong connections, and the resources they need to continue their recovery journey with confidence. * Join a Mission-Driven, Nationally Recognized Organization: We’re accredited by the Joint Commission and backed by TPG’s Rise Fund, with 18 locations and Telehealth services nationwide. * Champion the Continuum of Care: Be a key player in ensuring clients transition successfully from treatment into long-term recovery supports. * Work in Partnership: Collaborate with clinical, operational, and business development teams, as well as families and external partners, to make sure no detail is missed. * Enjoy Comprehensive Benefits: Including medical, vision, and dental insurance; whole and term life insurance; short- and long-term disability coverage; 401(k) with employer match; paid time off and holidays; and wellness, assistance, and referral programs.

APPLY NOW!

If you're passionate about building bridges to lasting recovery and ensuring every patient has a plan beyond our doors, apply today and help us continue making a difference at Banyan Treatment Centers. WE ARE AN EQUAL OPPORTUNITY EMPLOYER AND WELCOME APPLICANTS OF ALL BACKGROUNDS. WE ENCOURAGE VETERANS, ACTIVE-DUTY MILITARY, AND FIRST RESPONDERS TO APPLY IN

SUPPORT OF OUR FIRST RESPONDERS PROGRAM.